Provider Demographics
NPI:1407058696
Name:DOZIER, LORETTA SABINA
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:SABINA
Last Name:DOZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 HAMMACHER AVE SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-7633
Mailing Address - Country:US
Mailing Address - Phone:321-728-2251
Mailing Address - Fax:
Practice Address - Street 1:990 HAMMACHER AVE SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-7633
Practice Address - Country:US
Practice Address - Phone:321-728-2251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7261235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist