Provider Demographics
NPI:1942841796
Name:DUNNUM, BRITTANY HELEN
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:HELEN
Last Name:DUNNUM
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 1:1721 W IDAHO ST APT 216
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5274
Mailing Address - Country:US
Mailing Address - Phone:608-632-5045
Mailing Address - Fax:
Practice Address - Street 1:1409 W MAIN ST STE 120
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5215
Practice Address - Country:US
Practice Address - Phone:208-938-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDTSLP-5375235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist