Provider Demographics
NPI:1548415714
Name:HUFFMAN, DAWN MARIE FEA (MSP)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MARIE FEA
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:MSP
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:FEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSP
Mailing Address - Street 1:RR 2 BOX 290
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9340
Mailing Address - Country:US
Mailing Address - Phone:304-667-1527
Mailing Address - Fax:
Practice Address - Street 1:112 J D PARK RD STE 1
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9034
Practice Address - Country:US
Practice Address - Phone:304-647-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1392235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist