Provider Demographics
NPI:1780710996
Name:MILLER, DAWN MCDOUGAL (MME, MT-BC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MCDOUGAL
Last Name:MILLER
Suffix:
Gender:F
Credentials:MME, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 RANIER CT N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-1923
Mailing Address - Country:US
Mailing Address - Phone:763-478-2924
Mailing Address - Fax:
Practice Address - Street 1:4550 RANIER CT N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-1923
Practice Address - Country:US
Practice Address - Phone:763-478-2924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist