Individual
THERESA CHARLENE DAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
555 MOUNT PROSPECT AVE APT 15M, NEWARK, NJ 07104-1543
(973) 350-1389
(973) 482-3040
Mailing address
555 MOUNT PROSPECT AVE APT 15M, NEWARK, NJ 07104-1543
(973) 350-1389
(973) 482-3040
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
NJ
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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