Provider Demographics
NPI:1568241412
Name:DUNN, KENNETH (PSS, CRS)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:PSS, CRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BEAR CREEK LN # D27
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-1602
Mailing Address - Country:US
Mailing Address - Phone:828-793-3733
Mailing Address - Fax:
Practice Address - Street 1:110 BEAR CREEK LN # D27
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-1602
Practice Address - Country:US
Practice Address - Phone:828-793-3733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCM2023-10648-01175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist