Individual
JONATHON DAWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
219 N BROADWAY ST, POPLAR BLUFF, MO 63901-5135
(573) 712-2431
Mailing address
219 N BROADWAY ST, POPLAR BLUFF, MO 63901-5135
(573) 712-2431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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