Provider Demographics
NPI:1770903528
Name:DAWKINS, TAMARA STACEY (PHD)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:STACEY
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RENEE LYNN CT
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-6511
Mailing Address - Country:US
Mailing Address - Phone:919-966-3109
Mailing Address - Fax:919-966-4003
Practice Address - Street 1:100 RENEE LYNN CT
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-6511
Practice Address - Country:US
Practice Address - Phone:919-966-3109
Practice Address - Fax:919-966-4003
Is Sole Proprietor?:No
Enumeration Date:2014-04-20
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103073103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool