Provider Demographics
NPI:1336290816
Name:CYPHER, DAWN JARVIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:JARVIE
Last Name:CYPHER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:JENNIFER
Other - Last Name:JARVIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:361 WALTON ST
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-2027
Mailing Address - Country:US
Mailing Address - Phone:717-610-4328
Mailing Address - Fax:717-569-7762
Practice Address - Street 1:2215 DUTCH GOLD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1940
Practice Address - Country:US
Practice Address - Phone:717-569-8972
Practice Address - Fax:717-569-7762
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007067235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1017902820001OtherPA MEDICAL ASSISTANCE