Provider Demographics
NPI:1548835002
Name:DEAN, PEYTON (MS CCC-CLP)
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:MS CCC-CLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 TAMARACK AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45207-1317
Mailing Address - Country:US
Mailing Address - Phone:304-546-6580
Mailing Address - Fax:
Practice Address - Street 1:2990 RIGGS RD
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-3029
Practice Address - Country:US
Practice Address - Phone:859-727-9330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist