Provider Demographics
NPI:1831794643
Name:DUNN, MARISSA GABRIELLE (RBT)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:GABRIELLE
Last Name:DUNN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 ARBORDALE CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-3003
Mailing Address - Country:US
Mailing Address - Phone:919-621-1070
Mailing Address - Fax:
Practice Address - Street 1:314 CHAPANOKE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3400
Practice Address - Country:US
Practice Address - Phone:919-773-2020
Practice Address - Fax:919-773-1044
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-21-166882106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician