Provider Demographics
NPI:1497031769
Name:ANGLE, DAWN M (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:M
Last Name:ANGLE
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 AVON CT APT 18
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-1689
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 W WATER ST
Practice Address - Street 2:SUITE 108
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5627
Practice Address - Country:US
Practice Address - Phone:810-232-2766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010937081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical