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General NPI Number Information
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NPI Number | 1174711014
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Entity Type | Organization
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Legal Business Name | CENTER FOR LIVING ENRICHMENT
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 1170 S MAIN ST SUITE C
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City | WAYNESVILLE
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State | NC
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Zip | 28786-2242
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Country | US
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Telephone | 828-456-1999
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Fax | 828-456-2333
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Provider Business Mailing Address
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Address Line | 1170 SOUTH MAIN ST SUITE C
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City | WAYNESVILLE
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State | NC
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Zip | 28786-2410
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Country | US
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Telephone | 828-456-1999
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Fax | 828-456-2333
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Authorized Official
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Title or Position | DR/OWNER
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Name | DR. JEFFREY ALLAN DUNN
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Credential | PHD, LCSW
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Telephone | 828-456-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C004778
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License Number State | NC
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