Provider Demographics
NPI:1841541018
Name:CARDINAL, DAWN MICHELLE (MOTR/L)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MICHELLE
Last Name:CARDINAL
Suffix:
Gender:F
Credentials:MOTR/L
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Other - First Name:
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Mailing Address - Street 1:1211 S DOUGLAS HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4982
Mailing Address - Country:US
Mailing Address - Phone:307-670-9191
Mailing Address - Fax:307-670-9193
Practice Address - Street 1:102 BROWNFIELD RD
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633-2555
Practice Address - Country:US
Practice Address - Phone:307-298-5758
Practice Address - Fax:307-670-9193
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WYOTR-681225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation