Healthcare Provider Details
I. General information
NPI: 1326295429
Provider Name (Legal Business Name): JEANNI L. DUNAGAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/20/2008
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10350 E DAKOTA AVE
DENVER CO
80247-1314
US
IV. Provider business mailing address
10350 E DAKOTA AVE
DENVER CO
80247-1314
US
V. Phone/Fax
- Phone: 303-338-3800
- Fax:
- Phone: 303-338-3800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | C2198 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | T0532 |
| License Number State | OR |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 884 |
| License Number State | CO |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 5304 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: