Provider Demographics
NPI:1124308226
Name:ADAMS, DIONNE HELEN (LMT REG CPHT)
Entity type:Individual
Prefix:MS
First Name:DIONNE
Middle Name:HELEN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMT REG CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 GERTRUDE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526
Mailing Address - Country:US
Mailing Address - Phone:850-449-0974
Mailing Address - Fax:
Practice Address - Street 1:2315 GERTRUDE CIR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-1403
Practice Address - Country:US
Practice Address - Phone:850-449-0974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA61024225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003771100Medicaid