Provider Demographics
NPI:1124851936
Name:EGGLEFIELD, DAKOTA ALEXANDRA (PHD)
Entity type:Individual
Prefix:
First Name:DAKOTA
Middle Name:ALEXANDRA
Last Name:EGGLEFIELD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 BEACON ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-1418
Mailing Address - Country:US
Mailing Address - Phone:941-544-0508
Mailing Address - Fax:
Practice Address - Street 1:1 BOWDOIN SQ
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2927
Practice Address - Country:US
Practice Address - Phone:617-643-3997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist