Provider Demographics
NPI:1396917712
Name:BAWEK, DENA N (MACCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:N
Last Name:BAWEK
Suffix:
Gender:F
Credentials:MACCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N7878 410TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54767-8313
Mailing Address - Country:US
Mailing Address - Phone:715-778-5078
Mailing Address - Fax:
Practice Address - Street 1:N7878 410TH ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:WI
Practice Address - Zip Code:54767-8313
Practice Address - Country:US
Practice Address - Phone:715-778-5078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist