Jackson, Dawn
Jackson, Dawn is an individual health care provider with primary practice located at 9900 W Sample Rd Ste 300 , Coral Springs FL 33065-4077. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jackson, Dawn can be contacted via phone (954) 320-7881.Contact Information
Primary practice address
9900 W Sample Rd Ste 300
Coral Springs FL 33065-4077
Phone: (954) 320-7881
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 015925-1 | New York |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY8115 | Florida |
Profile Details
| NPI number | 1215973425 |
|---|---|
| LBN Legal business name | Jackson, Dawn |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Jun 13th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215973425 | NPPES |
| New York | MEDICAID | 02666544 |
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