Provider Demographics
NPI:1912673526
Name:ZOLLARS, DAWN MARIE (LICSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:ZOLLARS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:MN
Mailing Address - Zip Code:56081-1239
Mailing Address - Country:US
Mailing Address - Phone:507-920-7878
Mailing Address - Fax:
Practice Address - Street 1:403 4TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:MN
Practice Address - Zip Code:56081-1239
Practice Address - Country:US
Practice Address - Phone:507-920-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12976101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health