Provider Demographics
NPI:1043765761
Name:DUNLOW, MONA (HIS)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:DUNLOW
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E BOULEVARD STE B
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2781
Mailing Address - Country:US
Mailing Address - Phone:252-789-4008
Mailing Address - Fax:
Practice Address - Street 1:603 E BOULEVARD STE B
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2781
Practice Address - Country:US
Practice Address - Phone:252-789-4008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1500237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist