Provider Demographics
NPI:1902192107
Name:DAWSON, DEBBY M (MS,CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBBY
Middle Name:M
Last Name:DAWSON
Suffix:
Gender:F
Credentials:MS,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 SW 461 RD
Mailing Address - Street 2:
Mailing Address - City:EL DORADO SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64744-7411
Mailing Address - Country:US
Mailing Address - Phone:417-876-7204
Mailing Address - Fax:
Practice Address - Street 1:76 SE HIGHWAY WW
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:MO
Practice Address - Zip Code:64776-6239
Practice Address - Country:US
Practice Address - Phone:417-646-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-26
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004016666235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist