Provider Demographics
NPI:1760925622
Name:JARNAGIN, DAWN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:JARNAGIN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 FOX CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-3262
Mailing Address - Country:US
Mailing Address - Phone:865-659-6070
Mailing Address - Fax:
Practice Address - Street 1:3727 FOX CREEK RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:TN
Practice Address - Zip Code:37777-3262
Practice Address - Country:US
Practice Address - Phone:865-659-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP 0000006050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist