Provider Demographics
NPI:1780189225
Name:DAUTANT, RENEA
Entity Type:Individual
Prefix:MRS
First Name:RENEA
Middle Name:
Last Name:DAUTANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:22405-1421
Mailing Address - Country:US
Mailing Address - Phone:540-371-1415
Mailing Address - Fax:
Practice Address - Street 1:501 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:VA
Practice Address - Zip Code:22405-1421
Practice Address - Country:US
Practice Address - Phone:540-371-1415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist