Provider Demographics
NPI:1518382928
Name:DAKEN, MARCIE
Entity type:Individual
Prefix:MRS
First Name:MARCIE
Middle Name:
Last Name:DAKEN
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 1:266 PETROSE CIR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-2940
Mailing Address - Country:US
Mailing Address - Phone:203-525-7823
Mailing Address - Fax:
Practice Address - Street 1:266 PETROSE CIR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-2940
Practice Address - Country:US
Practice Address - Phone:203-525-7823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst