Provider Demographics
NPI:1659829927
Name:NEWLAN, DAWN (ESMHL, ES4H)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:NEWLAN
Suffix:
Gender:F
Credentials:ESMHL, ES4H
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7370 MARTEN RD
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-6581
Mailing Address - Country:US
Mailing Address - Phone:417-455-1200
Mailing Address - Fax:
Practice Address - Street 1:7370 MARTEN RD
Practice Address - Street 2:
Practice Address - City:NEOSHO
Practice Address - State:MO
Practice Address - Zip Code:64850-6581
Practice Address - Country:US
Practice Address - Phone:417-455-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral