Provider Demographics
NPI:1548417223
Name:ANSERT, DAWN MICHELLE (SLP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:ANSERT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MICHELLE
Other - Last Name:ALESCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:4603 TIMBERWALK CT
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-6746
Mailing Address - Country:US
Mailing Address - Phone:703-864-6695
Mailing Address - Fax:888-830-3233
Practice Address - Street 1:4603 TIMBERWALK CT
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-6746
Practice Address - Country:US
Practice Address - Phone:703-864-6695
Practice Address - Fax:888-830-3233
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist