MEDICARE: DAWN CLAY M.S., 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	SP01830	RI

General Provider Information

NPI Number	:	1730592304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN CLAY M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	15 WILLIAM ELLERY PL
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-2856
Country	:	US
Telephone Number	:	817-721-1032
Fax Number	:

Provider Business Practice Location Address
First Line	:	5308 COPPER CREEK DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4559
Country	:	US
Telephone Number	:	817-721-1032
Fax Number	:

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

Provider Enumeration Date	:	06/11/2014
Last Update Date	:	10/05/2023

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Directions to “ DAWN CLAY M.S., CCC-SLP” Practice Location

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