Provider Demographics
NPI:1831557099
Name:DATTA, SHIKHA
Entity type:Individual
Prefix:
First Name:SHIKHA
Middle Name:
Last Name:DATTA
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 1:131 SOUTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-4470
Mailing Address - Country:US
Mailing Address - Phone:774-563-8707
Mailing Address - Fax:
Practice Address - Street 1:131 SOUTHGATE DR
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-4470
Practice Address - Country:US
Practice Address - Phone:774-563-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker