Doctor Name: | SARAH SELLERGREN DUNN |
NPI Number: | 1366692410 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LPC |
License Number: | LPC 3979 |
Business Practice Address: | 60 E Little Ave Suite 2 Driggs, ID - 834225224 |
Business Phone Number: | 2082015686 |
Business Fax Number: | |
Mailing Address: | 3240 N 3000 W, TETONIA |
State: | ID |
Postal Code: | 834524821 |
Phone Number: | 2082015686 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2008 |
NPI Last Update Date: | 09/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC 3979 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |