Provider Demographics
NPI:1083166631
Name:DERA, DAWN CONTENTO (SLP, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:CONTENTO
Last Name:DERA
Suffix:
Gender:F
Credentials:SLP, CCC-SLP
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:ANNE
Other - Last Name:CONTENTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13139 NEW PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2675
Mailing Address - Country:US
Mailing Address - Phone:703-435-5978
Mailing Address - Fax:866-484-4155
Practice Address - Street 1:13139 NEW PARKLAND DR
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2675
Practice Address - Country:US
Practice Address - Phone:703-435-5978
Practice Address - Fax:866-484-4155
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist