Provider Demographics
NPI:1780749887
Name:RAFFA-YOO, DAWN MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:RAFFA-YOO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:RAFFA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:21 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1134
Mailing Address - Country:US
Mailing Address - Phone:609-558-3690
Mailing Address - Fax:866-309-4180
Practice Address - Street 1:23 ROUTE 31 NORTH
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534
Practice Address - Country:US
Practice Address - Phone:609-613-0110
Practice Address - Fax:866-309-4180
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC051837001041C0700X
NJ35SI00488900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2751686OtherOXFORD
P2751686OtherOXFORD