Provider Demographics
NPI:1043059553
Name:STANLEY, DASHAW'KNA ELAINE
Entity type:Individual
Prefix:
First Name:DASHAW'KNA
Middle Name:ELAINE
Last Name:STANLEY
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 1:3531 E 42ND AVE APT 407
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5541
Mailing Address - Country:US
Mailing Address - Phone:907-615-1587
Mailing Address - Fax:
Practice Address - Street 1:3531 E 42ND AVE APT 407
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5541
Practice Address - Country:US
Practice Address - Phone:907-615-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician