Provider Demographics
NPI:1134269889
Name:SPRING, DAWN LYNN
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:LYNN
Last Name:SPRING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:LYNN
Other - Last Name:SPRING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:20 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2731
Mailing Address - Country:US
Mailing Address - Phone:631-648-0881
Mailing Address - Fax:
Practice Address - Street 1:20 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2731
Practice Address - Country:US
Practice Address - Phone:631-648-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011194235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist