Healthcare Provider Details

I. General information

NPI: 1679629752
Provider Name (Legal Business Name): PATRICIA JENKINS DUNSTON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7852 16TH ST. NW
WASHINGTON DC
20012
US

IV. Provider business mailing address

1366 TEWKESBURY PL NW
WASHINGTON DC
20012-2922
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-5008
  • Fax:
Mailing address:
  • Phone: 202-829-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY1154
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: