Provider Demographics
NPI:1992835243
Name:MACDONALD, DAWN MARIE (MA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:RACKLIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:9 YALE AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-2337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10J GILL ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1721
Practice Address - Country:US
Practice Address - Phone:781-932-2888
Practice Address - Fax:781-932-9809
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist