Provider Demographics
NPI:1245061613
Name:DUNHAM, KINSIE JEAN (PHD)
Entity type:Individual
Prefix:
First Name:KINSIE
Middle Name:JEAN
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 LYNESS ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4819
Mailing Address - Country:US
Mailing Address - Phone:214-566-0450
Mailing Address - Fax:
Practice Address - Street 1:77 LYNESS ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4819
Practice Address - Country:US
Practice Address - Phone:214-566-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist