Provider Demographics
NPI:1821862673
Name:DYKEMAN, ANNE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:DYKEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:SIDORENKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:601 THREE ISLANDS BLVD APT 411
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2847
Mailing Address - Country:US
Mailing Address - Phone:785-375-5992
Mailing Address - Fax:
Practice Address - Street 1:601 THREE ISLANDS BLVD APT 411
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2847
Practice Address - Country:US
Practice Address - Phone:785-375-5992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health