Provider Demographics
NPI:1447820261
Name:KURDI, DINA MAKRAM
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:MAKRAM
Last Name:KURDI
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 1:1525 BROWN CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4627
Mailing Address - Country:US
Mailing Address - Phone:850-296-5992
Mailing Address - Fax:
Practice Address - Street 1:2331 HANSEN CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4859
Practice Address - Country:US
Practice Address - Phone:850-320-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician