Provider Demographics
NPI:1578797767
Name:SUTTON-DUNN, VERONA M (MED, MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VERONA
Middle Name:M
Last Name:SUTTON-DUNN
Suffix:
Gender:F
Credentials:MED, MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7216 RUSTIC MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-2505
Mailing Address - Country:US
Mailing Address - Phone:702-809-3680
Mailing Address - Fax:
Practice Address - Street 1:7216 RUSTIC MEADOW ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-2505
Practice Address - Country:US
Practice Address - Phone:702-809-3680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-659235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1005005588Medicaid