Provider Demographics
NPI:1881129104
Name:TAYLOR GIZZIO, DAWN MICHELLE
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MICHELLE
Last Name:TAYLOR GIZZIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 CHICHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER CHICHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19014-2313
Mailing Address - Country:US
Mailing Address - Phone:610-485-5335
Mailing Address - Fax:
Practice Address - Street 1:2205 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2428
Practice Address - Country:US
Practice Address - Phone:302-893-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional