Provider Demographics
NPI:1265976633
Name:DIQUATTRO, DAWN (MA LMFT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:DIQUATTRO
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4087 COTTAGE HILL RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-4226
Mailing Address - Country:US
Mailing Address - Phone:251-518-1178
Mailing Address - Fax:
Practice Address - Street 1:4087 COTTAGE HILL RD BLDG B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4226
Practice Address - Country:US
Practice Address - Phone:251-518-1178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL445106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist