Provider Demographics
NPI:1851045181
Name:DACQUEL, CATHY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:DACQUEL
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 1:132 AZALEA POINT DR N
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3663
Mailing Address - Country:US
Mailing Address - Phone:904-280-0044
Mailing Address - Fax:
Practice Address - Street 1:132 AZALEA POINT DR N
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-3663
Practice Address - Country:US
Practice Address - Phone:904-280-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-06
Last Update Date:2022-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator