Provider Demographics
NPI:1851629141
Name:DAWSON, JAMES CAVAN
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CAVAN
Last Name:DAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 W HOMOSASSA TRL STE 2
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34448-2855
Mailing Address - Country:US
Mailing Address - Phone:352-621-0502
Mailing Address - Fax:352-621-0503
Practice Address - Street 1:7990 W HOMOSASSA TRL STE 2
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34448-2855
Practice Address - Country:US
Practice Address - Phone:352-621-0502
Practice Address - Fax:352-621-0503
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0-07-2187103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst