Provider Demographics
NPI:1326302944
Name:DAUZAT, DANA LYNNE
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LYNNE
Last Name:DAUZAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:LYNN
Other - Last Name:PENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 GAP RD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-8679
Mailing Address - Country:US
Mailing Address - Phone:870-793-8900
Mailing Address - Fax:870-793-8929
Practice Address - Street 1:1335 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7334
Practice Address - Country:US
Practice Address - Phone:870-793-8900
Practice Address - Fax:870-793-8929
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health