Provider Demographics
NPI:1184420002
Name:DAWSON, EMILY BROOKE (COT/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BROOKE
Last Name:DAWSON
Suffix:
Gender:
Credentials:COT/L
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:BROOKE
Other - Last Name:CANTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:3504 GAMBLE RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-2910
Mailing Address - Country:US
Mailing Address - Phone:803-522-0155
Mailing Address - Fax:
Practice Address - Street 1:181 TOWN CREEK RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5841
Practice Address - Country:US
Practice Address - Phone:803-522-0155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5406224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant