Provider Demographics
NPI:1023744414
Name:DUNKELBERGER, KATHRYN (MT-BC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DUNKELBERGER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 ARDMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-4125
Mailing Address - Country:US
Mailing Address - Phone:253-691-1186
Mailing Address - Fax:
Practice Address - Street 1:38257 MOUND RD
Practice Address - Street 2:BLDG D - SUITE 200
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:253-691-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist