Provider Demographics
NPI:1538921333
Name:DAWSON, SAMANTHA JANE (CDCA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JANE
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5743 PRICE RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1493
Mailing Address - Country:US
Mailing Address - Phone:513-264-4874
Mailing Address - Fax:
Practice Address - Street 1:7593 TYLERS PLACE BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6308
Practice Address - Country:US
Practice Address - Phone:513-644-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator