Provider Demographics
NPI:1780630970
Name:WESTBROOK, DAWNA CAROLA (MALMSW)
Entity Type:Individual
Prefix:MS
First Name:DAWNA
Middle Name:CAROLA
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:MALMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11052 N CLIO RD
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-2313
Mailing Address - Country:US
Mailing Address - Phone:810-320-6718
Mailing Address - Fax:810-496-4763
Practice Address - Street 1:1422 W. COURT STREET
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503
Practice Address - Country:US
Practice Address - Phone:810-320-6718
Practice Address - Fax:810-496-4763
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010580361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical