Provider Demographics
NPI:1629448253
Name:FLOEGE, DAWN (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:FLOEGE
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 N WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1331
Mailing Address - Country:US
Mailing Address - Phone:317-361-2870
Mailing Address - Fax:
Practice Address - Street 1:1012 N WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1331
Practice Address - Country:US
Practice Address - Phone:317-361-2870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008196225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics