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General NPI Number Information
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NPI Number | 1154674562
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Entity Type | Organization
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Legal Business Name | DUNAHOO PSYCHOLOGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/23/2012
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 540 RIVERSIDE DR SUITE 7
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City | SALISBURY
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State | MD
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Zip | 21801-5352
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Country | US
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Telephone | 410-219-3555
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Fax | 410-219-2666
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Provider Business Mailing Address
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Address Line | 540 RIVERSIDE DR SUITE 7
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City | SALISBURY
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State | MD
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Zip | 21801-5352
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Country | US
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Telephone | 410-219-3555
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Fax | 410-219-2666
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLA L. DUNAHOO
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Credential | PH.D.
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Telephone | 410-219-3555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 03967
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License Number State | MD
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