Provider Demographics
NPI:1629686514
Name:HANDROW, DANA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:HANDROW
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:KIPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:5507 28TH ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-4294
Mailing Address - Country:US
Mailing Address - Phone:608-239-6652
Mailing Address - Fax:
Practice Address - Street 1:5507 28TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-4294
Practice Address - Country:US
Practice Address - Phone:608-239-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist