Provider Demographics
NPI:1750861399
Name:DAILEY, NAKIA TAMIKA TAYLOR (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:NAKIA
Middle Name:TAMIKA TAYLOR
Last Name:DAILEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:113 GULF TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-4745
Mailing Address - Country:US
Mailing Address - Phone:561-351-8741
Mailing Address - Fax:
Practice Address - Street 1:113 GULF TERRACE LN
Practice Address - Street 2:
Practice Address - City:PORT SAINT JOE
Practice Address - State:FL
Practice Address - Zip Code:32456-4745
Practice Address - Country:US
Practice Address - Phone:561-351-8741
Practice Address - Fax:850-743-4088
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0020127.00Medicaid