Individual
DAWN BOUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
236 SIMPSON AVE, ELKHART, IN 46516-4666
(574) 293-0052
Mailing address
236 SIMPSON AVE, ELKHART, IN 46516-4666
(574) 293-0052
(574) 293-3744
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
34008244A
IN
Other
Enumeration date
10/21/2015
Last updated
09/23/2019
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