Provider Demographics
NPI:1821385238
Name:SMITLEY, DAWN MARIE (LSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:SMITLEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:AVONMORE
Mailing Address - State:PA
Mailing Address - Zip Code:15618-9721
Mailing Address - Country:US
Mailing Address - Phone:724-681-5195
Mailing Address - Fax:
Practice Address - Street 1:2402 HOOKSTOWN GRADE RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:PA
Practice Address - Zip Code:15026-1814
Practice Address - Country:US
Practice Address - Phone:412-203-3723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128677104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker