Provider Demographics
NPI:1598520983
Name:DAWKINS, TARRA CY'MONE (LMT)
Entity Type:Individual
Prefix:MS
First Name:TARRA
Middle Name:CY'MONE
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 NONAP RD APT 2201
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-5167
Mailing Address - Country:US
Mailing Address - Phone:443-793-7622
Mailing Address - Fax:
Practice Address - Street 1:141 NONAP RD APT 2201
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-5167
Practice Address - Country:US
Practice Address - Phone:443-793-7622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT139484225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist