Individual
DUSTY DAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3282 MALLARD COVE LN, FORT WAYNE, IN 46804-2883
(812) 558-0574
Mailing address
1623 S MAYFIELD DR, FORT WAYNE, IN 46825-3279
(317) 499-2494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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