Provider Demographics
NPI:1891772182
Name:LATIMER-HEARN, DIONNA LOUISE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DIONNA
Middle Name:LOUISE
Last Name:LATIMER-HEARN
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:PSC 473
Mailing Address - Street 2:BOX 329
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96349-0329
Mailing Address - Country:US
Mailing Address - Phone:246-7724
Mailing Address - Fax:
Practice Address - Street 1:PSC 475
Practice Address - Street 2:BOX 1
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96350-1600
Practice Address - Country:US
Practice Address - Phone:243-4819
Practice Address - Fax:243-9869
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSPOtherSPEECH-LANGUAGE PATHOLOGY
DC12068055OtherNATIONAL LICENSURE SLP