Provider Demographics
NPI:1467545228
Name:VAN METER PATTON, DANA J (MS CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:J
Last Name:VAN METER PATTON
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:594 SW 1271
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MO
Mailing Address - Zip Code:64040
Mailing Address - Country:US
Mailing Address - Phone:816-726-7475
Mailing Address - Fax:
Practice Address - Street 1:594 SW 1271
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MO
Practice Address - Zip Code:64040
Practice Address - Country:US
Practice Address - Phone:816-726-7475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001005645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist