Provider Demographics
NPI:1518412097
Name:DICK, DAWN VICTORIA (LMT, NMT, FS, CHHC)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:VICTORIA
Last Name:DICK
Suffix:
Gender:F
Credentials:LMT, NMT, FS, CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7856 N WINDHOVER RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-4344
Mailing Address - Country:US
Mailing Address - Phone:727-687-0756
Mailing Address - Fax:
Practice Address - Street 1:7856 N WINDHOVER RD
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-4344
Practice Address - Country:US
Practice Address - Phone:727-687-0756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 174H00000X
FLMA60744225700000X
FL374U00000X
UT13789669-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No174H00000XOther Service ProvidersHealth Educator