Provider Demographics
NPI:1730459793
Name:DUNGAN, BRYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRYN
Middle Name:
Last Name:DUNGAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 E MAIN STREET
Mailing Address - Street 2:SUITE 304
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-2831
Mailing Address - Country:US
Mailing Address - Phone:317-384-7196
Mailing Address - Fax:317-203-7353
Practice Address - Street 1:2680 E MAIN STREET
Practice Address - Street 2:SUITE 304
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2831
Practice Address - Country:US
Practice Address - Phone:317-384-7196
Practice Address - Fax:317-203-7355
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042567A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical