Provider Demographics
NPI:1235646712
Name:O'KOON, BERNADETTE DAWN (MA, JD)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:DAWN
Last Name:O'KOON
Suffix:
Gender:F
Credentials:MA, JD
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:DAWN
Other - Last Name:LATUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, JD
Mailing Address - Street 1:3640 COLONEL GLENN HWY
Mailing Address - Street 2:117 HEALTH SCIENCES BUILDING
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45435
Mailing Address - Country:US
Mailing Address - Phone:937-775-3458
Mailing Address - Fax:937-775-3434
Practice Address - Street 1:3640 COLONEL GLENN HWY
Practice Address - Street 2:117 HEALTH SCIENCES BUILDING
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45435
Practice Address - Country:US
Practice Address - Phone:937-775-3458
Practice Address - Fax:937-775-3434
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program