Provider Demographics
NPI:1902314545
Name:DAINO, MINDY K (RSS)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:K
Last Name:DAINO
Suffix:
Gender:F
Credentials:RSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-2045
Mailing Address - Country:US
Mailing Address - Phone:580-889-6459
Mailing Address - Fax:
Practice Address - Street 1:271 E COURT ST
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525
Practice Address - Country:US
Practice Address - Phone:580-889-6459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist