MEDICARE: DAWN ALTMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SL004350L	PA

General Provider Information

NPI Number	:	1770020604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN ALTMAN

Provider Business Mailing Address
First Line	:	280 S RIDGE RD
Second Line	:
City	:	COAL CENTER
State	:	PA
Zip	:	15423-1018
Country	:	US
Telephone Number	:	724-255-8217
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 S RIDGE RD
Second Line	:
City	:	COAL CENTER
State	:	PA
Zip	:	15423-1018
Country	:	US
Telephone Number	:	724-255-8217
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2017
Last Update Date	:	01/30/2017

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Directions to “ DAWN ALTMAN ” Practice Location

Language	Start Address	Practice Location

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