Dawson, Bruce Lee

Dawson, Bruce Lee is an individual health care provider with primary practice located at 4313 University Ave , Des Moines IA 50311-3423. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Dawson, Bruce Lee can be contacted via phone (515) 255-4211.

Contact Information

Primary practice address
4313 University Ave Des Moines IA 50311-3423
Phone: (515) 255-4211
Fax: (515) 255-4196
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 750 Iowa

Profile Details

NPI number 1902954589
LBN Legal business name Dawson, Bruce Lee
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902954589 NPPES
Iowa Other 43675 WELLMARK BCBS
Iowa MEDICAID 0199497 WELLMARK BCBS

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