Provider Demographics
NPI:1124244579
Name:DAWKINS, DEBRA RUTH (M ED)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:RUTH
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 PALO DURO
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904
Mailing Address - Country:US
Mailing Address - Phone:325-944-2639
Mailing Address - Fax:325-944-2639
Practice Address - Street 1:2810 PALO DURO DR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-7429
Practice Address - Country:US
Practice Address - Phone:325-944-2639
Practice Address - Fax:325-944-2639
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09148101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional