Provider Demographics
NPI:1043348915
Name:DUNLAP, JONNA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JONNA
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JONNA
Other - Middle Name:
Other - Last Name:KRABBENHOFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 11536
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248
Mailing Address - Country:US
Mailing Address - Phone:480-652-6505
Mailing Address - Fax:888-887-4430
Practice Address - Street 1:283 N. ARIZONA AVENUE
Practice Address - Street 2:SUITE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225
Practice Address - Country:US
Practice Address - Phone:480-652-6505
Practice Address - Fax:888-887-4430
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3834103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ890138Medicaid