Provider Demographics
NPI:1508224023
Name:DUNN, MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:DUNN
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 1:200 W BULLARD AVE STE A4
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0857
Mailing Address - Country:US
Mailing Address - Phone:559-574-3002
Mailing Address - Fax:559-701-0332
Practice Address - Street 1:200 W BULLARD AVE STE A4
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0857
Practice Address - Country:US
Practice Address - Phone:559-574-3002
Practice Address - Fax:559-701-0332
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-29
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32357103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist