Provider Demographics
NPI:1568921203
Name:DAWSON, MEGHAN LEEANN (PLPC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LEEANN
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:LEEANN
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:216 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-2712
Mailing Address - Country:US
Mailing Address - Phone:573-982-9170
Mailing Address - Fax:417-944-1440
Practice Address - Street 1:216 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-2712
Practice Address - Country:US
Practice Address - Phone:573-982-9170
Practice Address - Fax:417-944-1440
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019006986101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional