Provider Demographics
NPI:1598102097
Name:DAWSON, GUY
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:
Last Name:DAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 WAYNE ST
Mailing Address - Street 2:B
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4526
Mailing Address - Country:US
Mailing Address - Phone:931-698-8482
Mailing Address - Fax:615-463-6605
Practice Address - Street 1:211 WAYNE ST
Practice Address - Street 2:B
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4526
Practice Address - Country:US
Practice Address - Phone:931-698-8482
Practice Address - Fax:615-463-6605
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health