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NPI 1164827713

NPI 1164827713 : MARY ELLEN DUNN : RENO, NV

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General NPI Number Information
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    NPI Number           |    1164827713
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    Entity Type          |    Individual 
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    Provider Name        |    MARY ELLEN DUNN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/24/2014
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    Last Update Date     |    10/24/2014
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Provider Practice Location Address
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    Address Line         |    575 E PLUMB LN 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89502-3540
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    Country              |    US
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    Telephone            |    775-329-0623
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    Fax                  |    775-337-2971
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Provider Business Mailing Address
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    Address Line         |    3089 JOSHUAPARK DR. 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89502
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    Country              |    US
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    Telephone            |    775-329-0623
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    Fax                  |    775-337-2971
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    01520-A
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    License Number State |    NV
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