Provider Demographics
NPI:1356352140
Name:DUNLAP, PATRICIA EILEEN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:EILEEN
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 DUVAL DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2986
Mailing Address - Country:US
Mailing Address - Phone:318-329-3933
Mailing Address - Fax:318-322-1134
Practice Address - Street 1:2404 DUVAL DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2986
Practice Address - Country:US
Practice Address - Phone:318-329-3933
Practice Address - Fax:318-322-1134
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3923101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor