Provider Demographics
NPI:1730311721
Name:DAWN ERIN CHRISTENSEN, PSYD, LLC
Entity Type:Organization
Organization Name:DAWN ERIN CHRISTENSEN, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:603-344-1819
Mailing Address - Street 1:PO BOX 625
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0625
Mailing Address - Country:US
Mailing Address - Phone:603-344-1819
Mailing Address - Fax:863-353-6081
Practice Address - Street 1:410 LAKE DAVENPORT CIR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-7530
Practice Address - Country:US
Practice Address - Phone:603-344-1819
Practice Address - Fax:863-353-6081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty