Provider Demographics
NPI:1740729573
Name:DEBORAH DYKES-HOWE
Entity type:Organization
Organization Name:DEBORAH DYKES-HOWE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DYKES-HOWE
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LMHC
Authorized Official - Phone:352-373-5115
Mailing Address - Street 1:2830 NW 41ST ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6667
Mailing Address - Country:US
Mailing Address - Phone:352-373-5115
Mailing Address - Fax:352-692-0004
Practice Address - Street 1:2830 NW 41ST ST
Practice Address - Street 2:SUITE J
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6667
Practice Address - Country:US
Practice Address - Phone:352-373-5115
Practice Address - Fax:352-692-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10249251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health