Provider Demographics
NPI:1134380785
Name:GRISWOLD, DAWN S (CRC)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:S
Last Name:GRISWOLD
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4243 SUNBEAM RD STE 3
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-8975
Mailing Address - Country:US
Mailing Address - Phone:904-448-0233
Mailing Address - Fax:904-448-0238
Practice Address - Street 1:4243 SUNBEAM RD STE 3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-8975
Practice Address - Country:US
Practice Address - Phone:904-448-0233
Practice Address - Fax:904-448-0238
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study