Provider Demographics
NPI:1942673744
Name:DUNN, TAMMY (MA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BORDEAUX DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8828
Mailing Address - Country:US
Mailing Address - Phone:318-680-6497
Mailing Address - Fax:
Practice Address - Street 1:104 BORDEAUX DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8828
Practice Address - Country:US
Practice Address - Phone:318-680-6497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health