Provider Demographics
NPI:1255477915
Name:TOWNSEND, DOROTHY ANN (CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ANN
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:CCCSLP
Other - Prefix:MRS
Other - First Name:DOROTHY
Other - Middle Name:ANN
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCCSLP
Mailing Address - Street 1:901 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-5810
Mailing Address - Country:US
Mailing Address - Phone:541-331-1261
Mailing Address - Fax:
Practice Address - Street 1:901 MAIN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-5810
Practice Address - Country:US
Practice Address - Phone:541-850-8611
Practice Address - Fax:541-850-8681
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11285235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist