Provider Demographics
NPI:1063031912
Name:LUKE, DAWN (MACCC-SLP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:LUKE
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 NE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-1597
Mailing Address - Country:US
Mailing Address - Phone:407-538-3386
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:4950 NE 6TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-1597
Practice Address - Country:US
Practice Address - Phone:407-538-3386
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist