Provider Demographics
NPI:1871193185
Name:KEYTON, DAWN ADAIR (MA, CFY- SLP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ADAIR
Last Name:KEYTON
Suffix:
Gender:F
Credentials:MA, CFY- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 LEXINGTON RD STE A&B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7924
Mailing Address - Country:US
Mailing Address - Phone:859-353-5445
Mailing Address - Fax:
Practice Address - Street 1:2150 LEXINGTON RD STE A&B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-7924
Practice Address - Country:US
Practice Address - Phone:859-353-5445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY266190235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100598430Medicaid