Provider Demographics
NPI:1962858449
Name:DUNKIN, SANDRA LYNNE (MA LLBSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LYNNE
Last Name:DUNKIN
Suffix:
Gender:F
Credentials:MA LLBSW
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Mailing Address - Street 1:2605 N WEST BAY SHORE DR
Mailing Address - Street 2:
Mailing Address - City:PESHAWBESTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:49682-9275
Mailing Address - Country:US
Mailing Address - Phone:231-534-7253
Mailing Address - Fax:231-534-7919
Practice Address - Street 1:2600 N STALLMAN ROAD
Practice Address - Street 2:
Practice Address - City:PESHAWBESTOWN
Practice Address - State:MI
Practice Address - Zip Code:49682-9275
Practice Address - Country:US
Practice Address - Phone:231-534-7253
Practice Address - Fax:231-534-7919
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6852090801104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker