Healthcare Provider Details

I. General information

NPI: 1679692826
Provider Name (Legal Business Name): DAWN R BUTLER M.A., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1522 CHEROKEE TRL
KNOXVILLE TN
37920-2205
US

IV. Provider business mailing address

1522 CHEROKEE TRL
KNOXVILLE TN
37920-2205
US

V. Phone/Fax

Practice location:
  • Phone: 865-549-5239
  • Fax: 865-594-5344
Mailing address:
  • Phone: 865-549-5239
  • Fax: 865-594-5344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA 0000001043
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: