Provider Demographics
NPI:1598194995
Name:DAWSON, VANESSA L
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:L
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 1:198 S. MCARTHUR DRIVE
Mailing Address - Street 2:
Mailing Address - City:CAMILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31730-6836
Mailing Address - Country:US
Mailing Address - Phone:229-336-2247
Mailing Address - Fax:
Practice Address - Street 1:198 S. MCARTHUR DRIVE
Practice Address - Street 2:
Practice Address - City:CAMILLA
Practice Address - State:GA
Practice Address - Zip Code:31730-6836
Practice Address - Country:US
Practice Address - Phone:229-336-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker