Basic Information
| Provider Information | |||||||||
| NPI: | 1861058851 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SARAH DAWSON | ||||||||
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| Mailing Information | |||||||||
| Address1: | 606 ARTHURSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | BETHANY BEACH | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199309589 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1270 KINGS HWY | ||||||||
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| City: | LEWES | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199581735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026456686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2019 | ||||||||
| LastUpdateDate: | 05/16/2019 | ||||||||
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| AuthorizedOfficialLastName: | DAWSON | ||||||||
| AuthorizedOfficialFirstName: | SARAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | SCHOOL PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8457024327 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TS0200X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | School |
ID Information
| ID | Type | State | Issuer | Description | 98748 | 01 | DE | STATE OF DELAWARE | OTHER |