Provider Demographics
NPI:1609048420
Name:PETERSON, DAWN M (AUD)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:M
Last Name:PETERSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3829 WOODLEY RD
Mailing Address - Street 2:BUILDING B
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1171
Mailing Address - Country:US
Mailing Address - Phone:419-474-9324
Mailing Address - Fax:419-474-9345
Practice Address - Street 1:1050 ISAAC STREETS DR
Practice Address - Street 2:SUITE 137
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3291
Practice Address - Country:US
Practice Address - Phone:419-474-9324
Practice Address - Fax:419-474-9345
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01547231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist