Provider Demographics
NPI:1285468736
Name:DEWEY, SAMANTHA JO (AUD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:JO
Last Name:DEWEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 S JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1936
Mailing Address - Country:US
Mailing Address - Phone:417-781-2311
Mailing Address - Fax:417-781-6477
Practice Address - Street 1:2311 S JACKSON AVE
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1936
Practice Address - Country:US
Practice Address - Phone:417-781-2311
Practice Address - Fax:417-781-6477
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024035192231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist