Provider Demographics
NPI:1184138323
Name:DAKOS, DIXIE DIANE
Entity type:Individual
Prefix:
First Name:DIXIE
Middle Name:DIANE
Last Name:DAKOS
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 1:2694 BRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MATLACHA
Mailing Address - State:FL
Mailing Address - Zip Code:33993-9791
Mailing Address - Country:US
Mailing Address - Phone:239-218-2269
Mailing Address - Fax:
Practice Address - Street 1:2694 BRUCE ST
Practice Address - Street 2:
Practice Address - City:MATLACHA
Practice Address - State:FL
Practice Address - Zip Code:33993-9791
Practice Address - Country:US
Practice Address - Phone:239-218-2269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health