Individual
DAWN STALLWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6980 N PORT WASHINGTON RD, MILWAUKEE, WI 53217-3900
(414) 773-4312
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 773-4312
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7040
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40994600
—
WI
Enumeration date
10/08/2008
Last updated
09/22/2023
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