Healthcare Provider Details

I. General information

NPI: 1154919991
Provider Name (Legal Business Name): DANIELLE DUNRUD LMSW-P; MSW U/S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 561 BOX 1571
FPO AP
96310-0016
US

IV. Provider business mailing address

2301 W COBURG PL
OKLAHOMA CITY OK
73170-4840
US

V. Phone/Fax

Practice location:
  • Phone: 315-255-8350
  • Fax:
Mailing address:
  • Phone: 805-801-0349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20457
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: