Provider Demographics
NPI:1508247784
Name:DUNLAP, DONNA MARIE GROW (LCPC, RPT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE GROW
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LCPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-1189
Mailing Address - Country:US
Mailing Address - Phone:410-758-8750
Mailing Address - Fax:410-758-8751
Practice Address - Street 1:207 N LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-1189
Practice Address - Country:US
Practice Address - Phone:410-758-8750
Practice Address - Fax:410-758-8751
Is Sole Proprietor?:No
Enumeration Date:2015-06-14
Last Update Date:2015-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6168101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional