Healthcare Provider Details

I. General information

NPI: 1053756684
Provider Name (Legal Business Name): ASHLI-JEAN DUNN LCSW, RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 NW 39TH ST
OKLAHOMA CITY OK
73112-8884
US

IV. Provider business mailing address

355 BEAL PKWY NW
FORT WALTON BEACH FL
32548-3917
US

V. Phone/Fax

Practice location:
  • Phone: 405-602-3171
  • Fax: 405-602-3226
Mailing address:
  • Phone: 850-744-0118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-199476
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: