MEDICARE: MRS. JESSICA EL DAKKAK MS, LMHC, CAP

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
1	101YM0800X	Mental Health Counselor	MH10420	FL

General Provider Information

NPI Number	:	1225344377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA EL DAKKAK MS, LMHC, CAP

Provider Business Mailing Address
First Line	:	10200 SUNSET DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3033
Country	:	US
Telephone Number	:	800-756-5792
Fax Number	:

Provider Business Practice Location Address
First Line	:	10200 SUNSET DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3033
Country	:	US
Telephone Number	:	800-756-5792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2010
Last Update Date	:	05/26/2016

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