Provider Demographics
NPI:1396823456
Name:DAKIN, KERRI MICHELLE (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:MICHELLE
Last Name:DAKIN
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W RANDOL MILL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4637
Mailing Address - Country:US
Mailing Address - Phone:817-277-7039
Mailing Address - Fax:817-801-3231
Practice Address - Street 1:101 W RANDOL MILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4637
Practice Address - Country:US
Practice Address - Phone:817-277-7039
Practice Address - Fax:817-801-3231
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51643231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G0590Medicare ID - Type Unspecified