Provider Demographics
NPI:1851502058
Name:SCOFIELD, DAWN MARIE (COTA,L,SDA)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:SCOFIELD
Suffix:
Gender:F
Credentials:COTA,L,SDA
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:LEFLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA
Mailing Address - Street 1:2873 GLASS MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHICKAMAUGA
Mailing Address - State:GA
Mailing Address - Zip Code:30707-3473
Mailing Address - Country:US
Mailing Address - Phone:706-375-2790
Mailing Address - Fax:
Practice Address - Street 1:2873 GLASS MILL RD
Practice Address - Street 2:
Practice Address - City:CHICKAMAUGA
Practice Address - State:GA
Practice Address - Zip Code:30707-3473
Practice Address - Country:US
Practice Address - Phone:706-375-2790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0000000097224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000000097OtherOT ASSISSTANT
GAOTA000093OtherOT ASSISSTANT
NM2309OtherOT ASSISSTANT