Provider Demographics
NPI:1164660585
Name:ISOM, DAWN EVANS (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:EVANS
Last Name:ISOM
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 1:2006 GOLDEN MORNING DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2965
Mailing Address - Country:US
Mailing Address - Phone:202-730-5137
Mailing Address - Fax:301-925-7037
Practice Address - Street 1:2006 GOLDEN MORNING DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2965
Practice Address - Country:US
Practice Address - Phone:202-730-5137
Practice Address - Fax:301-925-7037
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01308235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist