Provider Demographics
NPI:1801048681
Name:VERNON, DAWNA MARIE (MS, OTR,L)
Entity type:Individual
Prefix:
First Name:DAWNA
Middle Name:MARIE
Last Name:VERNON
Suffix:
Gender:F
Credentials:MS, OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 JENKINS BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT ULLA
Mailing Address - State:NC
Mailing Address - Zip Code:28125-8699
Mailing Address - Country:US
Mailing Address - Phone:877-991-7837
Mailing Address - Fax:
Practice Address - Street 1:1086 JENKINS BRANCH LN
Practice Address - Street 2:
Practice Address - City:MOUNT ULLA
Practice Address - State:NC
Practice Address - Zip Code:28125-8699
Practice Address - Country:US
Practice Address - Phone:877-991-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4418225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist