Provider Demographics
NPI:1083392963
Name:DUNLAP, DOROTHY DANIELLE
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:DANIELLE
Last Name:DUNLAP
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 1:210 COAL AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WV
Mailing Address - Zip Code:25130-1402
Mailing Address - Country:US
Mailing Address - Phone:304-601-3288
Mailing Address - Fax:
Practice Address - Street 1:210 COAL AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WV
Practice Address - Zip Code:25130-1402
Practice Address - Country:US
Practice Address - Phone:304-601-3288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant