Provider Demographics
NPI:1053727362
Name:O'SHEA-FARLEY, DAWN (MS)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:O'SHEA-FARLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7977 W FIEBRANTZ AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1952
Mailing Address - Country:US
Mailing Address - Phone:414-438-0844
Mailing Address - Fax:414-438-0844
Practice Address - Street 1:7977 W FIEBRANTZ AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1952
Practice Address - Country:US
Practice Address - Phone:414-438-0844
Practice Address - Fax:414-438-0844
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health