Provider Demographics
NPI:1710746623
Name:DUNN, DALLAS MICHELLE
Entity Type:Individual
Prefix:
First Name:DALLAS
Middle Name:MICHELLE
Last Name:DUNN
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 1:719 H ST APT 6
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-2272
Mailing Address - Country:US
Mailing Address - Phone:308-249-5706
Mailing Address - Fax:
Practice Address - Street 1:719 H ST APT 6
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-2272
Practice Address - Country:US
Practice Address - Phone:308-249-5706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician