Provider Demographics
NPI:1831896018
Name:BROTHERS, DAWN STAR (NMTCB, ARRT (R)(NM))
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:STAR
Last Name:BROTHERS
Suffix:
Gender:F
Credentials:NMTCB, ARRT (R)(NM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 STATE ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3538
Mailing Address - Country:US
Mailing Address - Phone:503-739-2314
Mailing Address - Fax:
Practice Address - Street 1:388 STATE ST STE 1100
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3538
Practice Address - Country:US
Practice Address - Phone:503-739-2314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health