Provider Demographics
NPI:1790035491
Name:JOKOVICH, DANA CHRISTINE (SLP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:CHRISTINE
Last Name:JOKOVICH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:CHRISTINE
Other - Last Name:SPROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:8446 CHICKASAW WAY
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-2632
Mailing Address - Country:US
Mailing Address - Phone:419-707-1529
Mailing Address - Fax:
Practice Address - Street 1:8446 CHICKASAW WAY
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-2632
Practice Address - Country:US
Practice Address - Phone:419-707-1529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP14767235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist