Healthcare Provider Details
I. General information
NPI: 1730478587
Provider Name (Legal Business Name): WILLAIM PATRICK DUNN LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/01/2011
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
575 E PLUMB LN
RENO NV
89502-3540
US
IV. Provider business mailing address
3089 JOSHUAPARK DR
RENO NV
89502-7710
US
V. Phone/Fax
- Phone: 775-329-0623
- Fax: 775-337-2971
- Phone: 775-329-0623
- Fax: 775-337-2971
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: