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NPI Code Detail

MEDICARE: MARLA DAKIN LCSW

MEDICARE: MARLA DAKIN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker004924CT

General Provider Information

NPI Number : 1548643810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLA DAKIN LCSW
Provider Business Mailing Address
First Line : 64 ANDREW DR
Second Line :
City : CANTON
State : CT
Zip : 06019-5000
Country : US
Telephone Number : 860-751-8283
Fax Number :
Provider Business Practice Location Address
First Line : 111 SIMSBURY RD STE 104
Second Line :
City : AVON
State : CT
Zip : 06001-3763
Country : US
Telephone Number : 860-255-4017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2015
Last Update Date : 07/20/2020

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Directions to “ MARLA DAKIN LCSW” Practice Location

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