Organization Name: | JODY L. DUNN |
NPI Number: | 1053674895 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JODY L DUNN (COUNSELOR) |
Mailing Address: | 1943 Highway 182 Raceland |
State: | LA US |
Postal Code: | 703943159 |
Phone Number: | 9858762697 |
Fax Number: | 9858762532 |
NPI Enumeration Date: | 06/18/2012 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2703 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |