Provider Demographics
NPI:1699854034
Name:STANISZEWSKI, DAWN KATHERINE (MSW)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:KATHERINE
Last Name:STANISZEWSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 DEFENSE HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7098
Mailing Address - Country:US
Mailing Address - Phone:410-573-5353
Mailing Address - Fax:410-224-2420
Practice Address - Street 1:133 DEFENSE HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7098
Practice Address - Country:US
Practice Address - Phone:410-573-5353
Practice Address - Fax:410-224-2420
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD037241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD102NMedicare ID - Type UnspecifiedGROUP #