Provider Demographics
NPI:1740790450
Name:STOKES, DALLAS LA TOI (BCBA)
Entity Type:Individual
Prefix:MS
First Name:DALLAS
Middle Name:LA TOI
Last Name:STOKES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3978 SORRENTO VALLEY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1436
Mailing Address - Country:US
Mailing Address - Phone:858-847-5788
Mailing Address - Fax:
Practice Address - Street 1:1880 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1853
Practice Address - Country:US
Practice Address - Phone:704-529-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-08
Last Update Date:2021-10-06
Deactivation Date:2021-07-16
Deactivation Code:
Reactivation Date:2021-10-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1740790450Medicaid