Provider Demographics
NPI:1184429078
Name:DYKES, SAMANTHA
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:DYKES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9641 NORCHESTER CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1849
Mailing Address - Country:US
Mailing Address - Phone:908-692-8040
Mailing Address - Fax:
Practice Address - Street 1:9641 NORCHESTER CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1849
Practice Address - Country:US
Practice Address - Phone:908-692-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-15
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician