Provider Demographics
NPI:1649811910
Name:MUNSON, APRIL DAWN
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:DAWN
Last Name:MUNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 WEEPING WILLOW
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-8990
Mailing Address - Country:US
Mailing Address - Phone:907-888-6103
Mailing Address - Fax:
Practice Address - Street 1:1116 WEEPING WILLOW
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-8990
Practice Address - Country:US
Practice Address - Phone:907-888-6103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY262335103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty