Provider Demographics
NPI:1790035491
Name:JOKOVICH, DANA CHRISTINE (SLP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:CHRISTINE
Last Name:JOKOVICH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:CHRISTINE
Other - Last Name:SPROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1900 MIDLAND TRL
Mailing Address - Street 2:SUITE 1 AND 2
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8141
Mailing Address - Country:US
Mailing Address - Phone:502-633-1007
Mailing Address - Fax:502-437-0624
Practice Address - Street 1:1900 MIDLAND TRL
Practice Address - Street 2:SUITE 1 AND 2
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-8141
Practice Address - Country:US
Practice Address - Phone:502-633-1007
Practice Address - Fax:502-437-0624
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4134235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist