Provider Demographics
NPI:1043758055
Name:DAKIN, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:DAKIN
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 1:2110 CRAFT RD
Mailing Address - Street 2:
Mailing Address - City:GRASS LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49240-9591
Mailing Address - Country:US
Mailing Address - Phone:517-937-3731
Mailing Address - Fax:
Practice Address - Street 1:151 2ND ST
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9647
Practice Address - Country:US
Practice Address - Phone:517-937-3731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001564225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist