Organization
BREAKING DAWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY DERAMUS LICSW (OWNER/CLINICAL SOCIAL WORKER)
(256) 490-4443
Entity
Organization
Contact information
Practice address
116 WILKERSON AVE, MADISON, AL 35756-4280
(256) 490-4443
(256) 262-4637
Mailing address
116 WILKERSON AVE, MADISON, AL 35756-4280
(256) 490-4443
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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