Provider Demographics
NPI:1508273202
Name:DAWSON, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 W HOLMES RD STE 135
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-0436
Mailing Address - Country:US
Mailing Address - Phone:517-803-3253
Mailing Address - Fax:517-580-4856
Practice Address - Street 1:913 W HOLMES RD STE 135
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-0436
Practice Address - Country:US
Practice Address - Phone:517-803-3253
Practice Address - Fax:517-580-4856
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014378101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor