Provider Demographics
NPI:1053429647
Name:COLLINS, DAWN M (PHD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:NOFZINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1033 UNIVERSITY PL STE 330
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3156
Mailing Address - Country:US
Mailing Address - Phone:847-869-9300
Mailing Address - Fax:847-869-2605
Practice Address - Street 1:1033 UNIVERSITY PL STE 330
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3156
Practice Address - Country:US
Practice Address - Phone:847-869-9300
Practice Address - Fax:847-869-2605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling