Provider Demographics
NPI:1669221891
Name:DUNN, MARY JULIA
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JULIA
Last Name:DUNN
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 1:299 COOPER RD STE A
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-2579
Mailing Address - Country:US
Mailing Address - Phone:678-243-9118
Mailing Address - Fax:855-463-3157
Practice Address - Street 1:299 COOPER RD STE A
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-2579
Practice Address - Country:US
Practice Address - Phone:678-243-9118
Practice Address - Fax:855-463-3157
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor