Provider Demographics
NPI:1598483380
Name:BARROW, DAKOTA
Entity type:Individual
Prefix:
First Name:DAKOTA
Middle Name:
Last Name:BARROW
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 1:30 S 15TH ST STE 1550
Mailing Address - Street 2:PMB 190234
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-5561
Mailing Address - Country:US
Mailing Address - Phone:215-608-0986
Mailing Address - Fax:215-608-0986
Practice Address - Street 1:30 S 15TH ST STE 1550
Practice Address - Street 2:PMB 190234
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-5561
Practice Address - Country:US
Practice Address - Phone:215-608-0986
Practice Address - Fax:215-608-0986
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0248291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical