Provider Demographics
NPI:1881312767
Name:DIKES, JAMIE ELIZABETH (MED, LPC, MT-BC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:DIKES
Suffix:
Gender:F
Credentials:MED, LPC, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TRAILS END RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-5500
Mailing Address - Country:US
Mailing Address - Phone:325-660-8092
Mailing Address - Fax:
Practice Address - Street 1:2 TRAILS END RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-5500
Practice Address - Country:US
Practice Address - Phone:325-660-8092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-17
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06888225A00000X
TX69924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist