Provider Demographics
NPI:1720253651
Name:LONG, DAWN DUGGER (SPED)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:DUGGER
Last Name:LONG
Suffix:
Gender:F
Credentials:SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:FL
Mailing Address - Zip Code:32333-4951
Mailing Address - Country:US
Mailing Address - Phone:850-539-4889
Mailing Address - Fax:
Practice Address - Street 1:3120 DOVER RD
Practice Address - Street 2:
Practice Address - City:HAVANA
Practice Address - State:FL
Practice Address - Zip Code:32333-4951
Practice Address - Country:US
Practice Address - Phone:850-539-4889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator