Provider Demographics
NPI:1851531131
Name:BARRETT, DAWN MARIE
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE
Last Name:BARRETT
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:PO BOX 673
Mailing Address - Street 2:
Mailing Address - City:SPARROW BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12780-0673
Mailing Address - Country:US
Mailing Address - Phone:845-858-6278
Mailing Address - Fax:845-858-6278
Practice Address - Street 1:303 WILSON RD
Practice Address - Street 2:
Practice Address - City:SPARROW BUSH
Practice Address - State:NY
Practice Address - Zip Code:12780-5439
Practice Address - Country:US
Practice Address - Phone:845-858-6278
Practice Address - Fax:845-858-6278
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010439-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist