Provider Demographics
NPI:1891938189
Name:PARRACK, JENNIFER DAWN DUNKLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DAWN DUNKLE
Last Name:PARRACK
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 1:62 S UNION RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6509
Mailing Address - Country:US
Mailing Address - Phone:716-352-9753
Mailing Address - Fax:
Practice Address - Street 1:62 S UNION RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14221-6509
Practice Address - Country:US
Practice Address - Phone:716-352-9753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY458103T00000X
NY018190-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist