Provider Demographics
NPI:1700523487
Name:PIACENTINI, DAKOTA LYNN
Entity Type:Individual
Prefix:MS
First Name:DAKOTA
Middle Name:LYNN
Last Name:PIACENTINI
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 1:714 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079-4851
Mailing Address - Country:US
Mailing Address - Phone:810-479-1807
Mailing Address - Fax:
Practice Address - Street 1:3104 KING RD
Practice Address - Street 2:
Practice Address - City:CHINA
Practice Address - State:MI
Practice Address - Zip Code:48054-1428
Practice Address - Country:US
Practice Address - Phone:810-328-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician