Provider Demographics
NPI:1508549106
Name:DUNBAR, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DUNBAR
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 1:218 ASPEN VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63021-4722
Mailing Address - Country:US
Mailing Address - Phone:314-703-6523
Mailing Address - Fax:
Practice Address - Street 1:218 ASPEN VILLAGE DR
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63021-4722
Practice Address - Country:US
Practice Address - Phone:314-703-6523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool