Provider Demographics
NPI:1720250392
Name:MCKINNEY, DAWN BRADLEY (AUD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:BRADLEY
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 BETHEL RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-1814
Mailing Address - Country:US
Mailing Address - Phone:614-442-7680
Mailing Address - Fax:614-569-3318
Practice Address - Street 1:1960 BETHEL RD
Practice Address - Street 2:SUITE 250
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-1814
Practice Address - Country:US
Practice Address - Phone:614-442-7680
Practice Address - Fax:614-569-3318
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01684231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist