Provider Demographics
NPI:1306257282
Name:LAKES, DIONNA (PP, BS)
Entity type:Individual
Prefix:
First Name:DIONNA
Middle Name:
Last Name:LAKES
Suffix:
Gender:F
Credentials:PP, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 HITCHITEE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-6016
Mailing Address - Country:US
Mailing Address - Phone:706-386-0135
Mailing Address - Fax:706-571-9242
Practice Address - Street 1:1220 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-5241
Practice Address - Country:US
Practice Address - Phone:706-571-9091
Practice Address - Fax:706-571-9242
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor