Provider Demographics
NPI:1205855590
Name:BUNNELL, ERIN KATHLEEN (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:KATHLEEN
Last Name:BUNNELL
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NV
Mailing Address - Zip Code:89403-7700
Mailing Address - Country:US
Mailing Address - Phone:805-714-6200
Mailing Address - Fax:805-268-7013
Practice Address - Street 1:201 RIVER RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NV
Practice Address - Zip Code:89403-7700
Practice Address - Country:US
Practice Address - Phone:805-714-6200
Practice Address - Fax:805-268-7013
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37182106H00000X
NV2878-R106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist