Provider Demographics
NPI:1679246995
Name:DAWKINS, OCTAVIA
Entity Type:Individual
Prefix:MS
First Name:OCTAVIA
Middle Name:
Last Name:DAWKINS
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 1:55 DODGE RD
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1205
Mailing Address - Country:US
Mailing Address - Phone:716-831-2700
Mailing Address - Fax:
Practice Address - Street 1:77 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1642
Practice Address - Country:US
Practice Address - Phone:716-834-6401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical