Provider Information for 1184004152
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Mrs. DAWN MARIE MUMAW LCSW, SAC
Sex: Female
NPI: 1184004152
Last Updated: 2024-04-16
Certification Date: 2024-04-16
Certification Date: 2024-04-16
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1184004152 | ||||||||||||||||||||
| Enumeration Date | 2015-06-04 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 6170 S ROSETREE PASS NEW BERLIN, WI 53151-8345 United States Phone: | Fax: | ||||||||||||||||||||
| Primary Practice Address | 6170 S ROSETREE PASS NEW BERLIN, WI 53151-8345 United States Phone: 126-232-7288 | Fax: | ||||||||||||||||||||
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