Provider Demographics
NPI:1760831697
Name:DUGAN, CRISTIN (AUD)
Entity Type:Individual
Prefix:
First Name:CRISTIN
Middle Name:
Last Name:DUGAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CRISTIN
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 W DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6312
Mailing Address - Country:US
Mailing Address - Phone:352-326-5253
Mailing Address - Fax:
Practice Address - Street 1:1108 W DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6312
Practice Address - Country:US
Practice Address - Phone:352-326-5253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30853231H00000X
FLAY2529231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist