Provider Demographics
NPI:1174389183
Name:DAWSON, TERRY KAY
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:KAY
Last Name:DAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 W RIVER RD S
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-6941
Mailing Address - Country:US
Mailing Address - Phone:440-396-3502
Mailing Address - Fax:
Practice Address - Street 1:2007 W RIVER RD S
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6941
Practice Address - Country:US
Practice Address - Phone:440-396-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant