Healthcare Provider Details
I. General information
NPI: 1902947708
Provider Name (Legal Business Name): TINA DUNBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/12/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 W MCCLANAHAN ST
OXFORD NC
27565-2927
US
IV. Provider business mailing address
PO BOX 1697
OXFORD NC
27565-1697
US
V. Phone/Fax
- Phone: 919-693-1671
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225C00000X |
| Taxonomy | Rehabilitation Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: