Provider Demographics
NPI:1700316213
Name:MICHAEL DUNN CENTER
Entity Type:Organization
Organization Name:MICHAEL DUNN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:
Authorized Official - Last Name:PUCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-376-3416
Mailing Address - Street 1:629 GALLAHER RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-4215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:629 GALLAHER RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-4215
Practice Address - Country:US
Practice Address - Phone:865-376-3416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty