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General NPI Number Information
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NPI Number | 1114714573
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Entity Type | Individual
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Provider Name | GEORGIANA DUNN FAMILY COUNSELOR
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Gender | Female
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 4516 BOAT CLUB RD STE 106
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City | FORT WORTH
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State | TX
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Zip | 76135-7020
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Country | US
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Telephone | 817-238-0106
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Fax |
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Provider Business Mailing Address
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Address Line | 917 FAIRWAY RANCH PKWY
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City | ROANOKE
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State | TX
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Zip | 76262-1285
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Country | US
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Telephone | 603-440-4937
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 205986
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License Number State | TX
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