Provider Demographics
NPI:1356870802
Name:MCMAHON, DANA GUILLORY I
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:GUILLORY
Last Name:MCMAHON
Suffix:I
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 1:316 DOLPHIN ST
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4234
Mailing Address - Country:US
Mailing Address - Phone:850-572-9821
Mailing Address - Fax:
Practice Address - Street 1:316 DOLPHIN ST
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4234
Practice Address - Country:US
Practice Address - Phone:850-572-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker