MEDICARE: MRS. DAWN ELAINE IRWIN-GROLEAU M.ED, CCC-SLP

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	SL004120L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	20036905	OTHER	PA	AMERIHEALTH MERCY
3	02249901	OTHER	PA	CAPITAL BLUE CROSS
4	IR1300111	OTHER	PA	HIGHMARK BLUE SHIELD
5	2586470	OTHER	PA	AETNA US HEALTHCARE HMO
6	1537903	OTHER	PA	GATEWAY
7	7083250	OTHER	PA	AETNA US HEALTHCARE PPO

General Provider Information

NPI Number	:	1912906884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN ELAINE IRWIN-GROLEAU M.ED, CCC-SLP

Provider Business Mailing Address
First Line	:	1135 OLDE W CHOCOLATE AVE
Second Line	:
City	:	HUMMELSTOWN
State	:	PA
Zip	:	17036-9188
Country	:	US
Telephone Number	:	717-833-5305
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 OLDE W CHOCOLATE AVE
Second Line	:
City	:	HUMMELSTOWN
State	:	PA
Zip	:	17036-9188
Country	:	US
Telephone Number	:	717-833-5305
Fax Number	:

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	01/27/2015

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Directions to “ MRS. DAWN ELAINE IRWIN-GROLEAU M.ED, CCC-SLP” Practice Location

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