Healthcare Provider Details

I. General information

NPI: 1073010187
Provider Name (Legal Business Name): JOHN R DUNN BS JD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOWELL HOUSE INC 555 MERRIMACK STREET
LOWELL MA
01854
US

IV. Provider business mailing address

1799 BODWELL RD UNIT 19
MANCHESTER NH
03109-5855
US

V. Phone/Fax

Practice location:
  • Phone: 978-459-8656
  • Fax: 978-937-2559
Mailing address:
  • Phone: 603-568-7317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: