Doctor Name: | DAWNELL PORCARO |
NPI Number: | 1760795512 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SLP006677 |
Business Practice Address: | 1020 Barber Creek Dr Ste 113 Watkinsville, GA - 306775980 |
Business Phone Number: | 7065839525 |
Business Fax Number: | 7065839526 |
Mailing Address: | 3615 Braselton Hwy Ste 103, DACULA |
State: | GA |
Postal Code: | 300195907 |
Phone Number: | 6783779634 |
Fax Number: | 6783779634 |
NPI Enumeration Date: | 07/22/2010 |
NPI Last Update Date: | 07/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP006677 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |