Individual
KELLY DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT, COTA
Contact information
Practice address
537 E FULTON ST, STOCKTON, CA 95204-2227
(209) 466-2066
(209) 466-2066
Mailing address
537 E FULTON ST, STOCKTON, CA 95204-2227
(209) 466-2066
(209) 466-2066
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-18-64087
WI
224Z00000X
Occupational Therapy Assistant
Primary
14631
NC
Other
Enumeration date
09/26/2018
Last updated
01/11/2022
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