Provider Demographics
NPI:1558427104
Name:DUNN-BELL, JACQUELINE MARIE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:MARIE
Last Name:DUNN-BELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 871004
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-6004
Mailing Address - Country:US
Mailing Address - Phone:734-422-2606
Mailing Address - Fax:734-422-2608
Practice Address - Street 1:8410 FLAMINGO ST
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1762
Practice Address - Country:US
Practice Address - Phone:734-422-2606
Practice Address - Fax:734-422-2608
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010152431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM95490017Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER