Provider Demographics
NPI:1588789952
Name:BURGIN, DAWN MICHELLE (BS)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MICHELLE
Last Name:BURGIN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2082 BRIDGE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-6376
Mailing Address - Country:US
Mailing Address - Phone:606-679-6574
Mailing Address - Fax:606-679-6574
Practice Address - Street 1:2082 BRIDGE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-6376
Practice Address - Country:US
Practice Address - Phone:606-679-6574
Practice Address - Fax:606-679-6574
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY754OtherFIRST STEPS