Provider Demographics
NPI:1427106731
Name:KEARNEY, DAWN ZACHARY (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ZACHARY
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 ARNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2076
Mailing Address - Country:US
Mailing Address - Phone:803-359-9456
Mailing Address - Fax:803-359-3195
Practice Address - Street 1:108 ARNWOOD CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2076
Practice Address - Country:US
Practice Address - Phone:803-359-9456
Practice Address - Fax:803-359-3195
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3268235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0451Medicaid