Provider Demographics
NPI:1356426951
Name:BUTZIN, DAWN NICOLE (MAC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:NICOLE
Last Name:BUTZIN
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:NICOLE
Other - Last Name:SPRANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1810 APPLETON ROAD
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952
Mailing Address - Country:US
Mailing Address - Phone:920-739-4226
Mailing Address - Fax:920-739-7639
Practice Address - Street 1:1810 APPLETON ROAD
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952
Practice Address - Country:US
Practice Address - Phone:920-739-4226
Practice Address - Fax:920-739-7639
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor