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General NPI Number Information
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NPI Number | 1053674895
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Entity Type | Organization
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Legal Business Name | JODY L. DUNN
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 1943 HIGHWAY 182
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City | RACELAND
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State | LA
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Zip | 70394-3159
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Country | US
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Telephone | 985-876-2697
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Fax | 985-876-2532
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Provider Business Mailing Address
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Address Line | 1943 HIGHWAY 182
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City | RACELAND
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State | LA
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Zip | 70394-3159
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Country | US
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Telephone | 985-876-2697
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Fax | 985-876-2532
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Authorized Official
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Title or Position | COUNSELOR
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Name | JODY L DUNN
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Credential | MA, LPC, LMFT
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Telephone | 985-876-2697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2703
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License Number State | LA
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