Provider Demographics
NPI:1518621796
Name:DAWSON, PAULINE ANDREA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:ANDREA
Last Name:DAWSON
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 NW 165TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6343
Mailing Address - Country:US
Mailing Address - Phone:786-623-4053
Mailing Address - Fax:
Practice Address - Street 1:520 NW 165TH ST STE 205
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6343
Practice Address - Country:US
Practice Address - Phone:786-623-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist