Provider Demographics
NPI:1952579351
Name:DUNN, LOUISE M (LIC AC, MAOM)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:M
Last Name:DUNN
Suffix:
Gender:F
Credentials:LIC AC, MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 D GREAT ROAD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720
Mailing Address - Country:US
Mailing Address - Phone:978-394-2658
Mailing Address - Fax:
Practice Address - Street 1:498 GREAT RD UNIT D
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3437
Practice Address - Country:US
Practice Address - Phone:978-394-2658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234584171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist