Provider Demographics
NPI:1457436727
Name:DUNN, STEPHEN (PHD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11215 OAK LEAF DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1317
Mailing Address - Country:US
Mailing Address - Phone:310-593-1315
Mailing Address - Fax:301-681-4699
Practice Address - Street 1:11215 OAK LEAF DR
Practice Address - Street 2:SUITE 108
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1317
Practice Address - Country:US
Practice Address - Phone:310-593-1315
Practice Address - Fax:301-681-4699
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03739103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical