Provider Demographics
NPI:1063981926
Name:CHEESEMAN, DAWN MARIE
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:CHEESEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:DEFESI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1597 RIDGEGATE CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1220
Mailing Address - Country:US
Mailing Address - Phone:775-345-4099
Mailing Address - Fax:
Practice Address - Street 1:1597 RIDGEGATE CIR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1220
Practice Address - Country:US
Practice Address - Phone:775-345-4099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation