Jennifer Phoenix Dawn, LCSW
Social Worker, Clinical in South Lake Tahoe, CA. Individual provider (NPI-1).
NPI number1760614366
StatusActive
Last updated in NPPESMay 31, 2019
Details
- NPI
- 1760614366
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Phoenix Dawn
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 14, 2009
- Last updated
- May 31, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 26121 | CA | Yes |
Practice location
1900 Lake Tahoe BlvdSouth Lake Tahoe, CA 96150-6305
Phone 530-573-7970
Mailing address
1900 Lake Tahoe BlvdSouth Lake Tahoe, CA 96150-6305
Phone 530-573-7970
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All 38 Clinical Social Worker providers in South Lake Tahoe · All 712 providers in South Lake Tahoe
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