Provider Demographics
NPI:1174614499
Name:DAWKINS, LORA LEA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:LORA
Middle Name:LEA
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 WOLF ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBU
Mailing Address - State:MS
Mailing Address - Zip Code:39705
Mailing Address - Country:US
Mailing Address - Phone:662-356-0005
Mailing Address - Fax:
Practice Address - Street 1:REGION III MENTAL HEALTH CENTER
Practice Address - Street 2:2434 SOUTH EASON
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-6942
Practice Address - Country:US
Practice Address - Phone:662-844-1717
Practice Address - Fax:662-680-5129
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM5823104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker