Provider Demographics
NPI:1568093524
Name:DAWN OPITZ-WHITE PSYD LLC
Entity Type:Organization
Organization Name:DAWN OPITZ-WHITE PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OPITZ-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:785-202-1689
Mailing Address - Street 1:322 HOUSTON ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6497
Mailing Address - Country:US
Mailing Address - Phone:785-202-1689
Mailing Address - Fax:
Practice Address - Street 1:322 HOUSTON ST STE 103
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6497
Practice Address - Country:US
Practice Address - Phone:785-202-1689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty