Provider Demographics
NPI:1295052967
Name:MILLARD, DAWN RACHAE (BA, BHRS)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:RACHAE
Last Name:MILLARD
Suffix:
Gender:F
Credentials:BA, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 CARRIE LN NW
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-9570
Mailing Address - Country:US
Mailing Address - Phone:405-226-7187
Mailing Address - Fax:405-373-4910
Practice Address - Street 1:1520 CARRIE LN NW
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:OK
Practice Address - Zip Code:73078-9570
Practice Address - Country:US
Practice Address - Phone:405-226-7187
Practice Address - Fax:405-373-4910
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst