Provider Demographics
NPI:1487001020
Name:DUNDON, CAROLYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:DUNDON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VT
Mailing Address - Zip Code:05443-1303
Mailing Address - Country:US
Mailing Address - Phone:802-989-8053
Mailing Address - Fax:
Practice Address - Street 1:14 SCHOOL ST
Practice Address - Street 2:SCHOOL HOUSE OFFICE SUITE 2
Practice Address - City:BRISTOL
Practice Address - State:VT
Practice Address - Zip Code:05443-1210
Practice Address - Country:US
Practice Address - Phone:802-989-8053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048.0112133103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist