Provider Demographics
NPI:1245708601
Name:DASHO, VICKI W
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:W
Last Name:DASHO
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 1:112 SPINDLE LN
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-9062
Mailing Address - Country:US
Mailing Address - Phone:803-319-7851
Mailing Address - Fax:
Practice Address - Street 1:112 SPINDLE LN
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-9062
Practice Address - Country:US
Practice Address - Phone:803-319-7851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-04
Last Update Date:2018-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health