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NPI Code Detail

MEDICARE: KATHERINE GORMAN DUNHAM

MEDICARE: KATHERINE GORMAN DUNHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor75527TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
175527OTHERTXTEXAS LPC

General Provider Information

NPI Number : 1336675081
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE GORMAN DUNHAM
Provider Business Mailing Address
First Line : 701 E 15TH ST STE 101
Second Line :
City : PLANO
State : TX
Zip : 75074-0708
Country : US
Telephone Number : 972-872-8487
Fax Number : 972-739-3535
Provider Business Practice Location Address
First Line : 701 E 15TH ST STE 101
Second Line :
City : PLANO
State : TX
Zip : 75074-0708
Country : US
Telephone Number : 972-872-8487
Fax Number : 972-739-3535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2017
Last Update Date : 04/06/2024

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Directions to “ KATHERINE GORMAN DUNHAM ” Practice Location

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