Healthcare Provider Details

I. General information

NPI: 1639003155
Provider Name (Legal Business Name): DAWNA RENEE DEWITT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 WALNUT ST
GREENVILLE MO
63944-8133
US

IV. Provider business mailing address

191 WALNUT ST
GREENVILLE MO
63944-8133
US

V. Phone/Fax

Practice location:
  • Phone: 573-224-5000
  • Fax:
Mailing address:
  • Phone: 573-224-5000
  • Fax: 573-224-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2018008238
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: