Provider Demographics
NPI:1659512176
Name:SMIDGA, DAWN (BS)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SMIDGA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 879
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-0879
Mailing Address - Country:US
Mailing Address - Phone:724-850-8118
Mailing Address - Fax:
Practice Address - Street 1:1380 ROUTE 286 HWY E
Practice Address - Street 2:SUITE 524, HIGHWAY EAST
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1461
Practice Address - Country:US
Practice Address - Phone:724-465-0369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor