Provider Demographics
NPI:1073321519
Name:DAWKINS, KAHLILAH
Entity type:Individual
Prefix:
First Name:KAHLILAH
Middle Name:
Last Name:DAWKINS
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 1:4725 W TRILBY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-1021
Mailing Address - Country:US
Mailing Address - Phone:813-785-6824
Mailing Address - Fax:
Practice Address - Street 1:4725 W TRILBY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33616-1021
Practice Address - Country:US
Practice Address - Phone:813-785-6824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool