Provider Demographics
NPI:1639399587
Name:HEATH, DAWN RAMONA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:RAMONA
Last Name:HEATH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14121 BROOKRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-2709
Mailing Address - Country:US
Mailing Address - Phone:972-386-0910
Mailing Address - Fax:
Practice Address - Street 1:9441 LYNDON B JOHNSON FWY
Practice Address - Street 2:#101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4545
Practice Address - Country:US
Practice Address - Phone:866-575-9846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106360225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation