Provider Demographics
NPI:1205250925
Name:WORNAT, DANA (MSCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:
Last Name:WORNAT
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 COUNTY ROAD 118
Mailing Address - Street 2:
Mailing Address - City:RIESEL
Mailing Address - State:TX
Mailing Address - Zip Code:76682-3795
Mailing Address - Country:US
Mailing Address - Phone:254-640-2842
Mailing Address - Fax:
Practice Address - Street 1:273 COUNTY ROAD 118
Practice Address - Street 2:
Practice Address - City:RIESEL
Practice Address - State:TX
Practice Address - Zip Code:76682-3795
Practice Address - Country:US
Practice Address - Phone:254-640-2842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14766235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist