Provider Demographics
NPI:1821782970
Name:AMARAL, DAWN SUZANNE
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:SUZANNE
Last Name:AMARAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:CHANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2077
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-2077
Mailing Address - Country:US
Mailing Address - Phone:707-467-2010
Mailing Address - Fax:833-895-1442
Practice Address - Street 1:780 S DORA ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5348
Practice Address - Country:US
Practice Address - Phone:707-467-9065
Practice Address - Fax:833-895-1442
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner