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General NPI Number Information
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NPI Number | 1225235658
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Entity Type | Individual
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Provider Name | JEANNE BUNKER LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2520 LONGVIEW ST SUITE 302
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City | AUSTIN
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State | TX
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Zip | 78705-4250
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Country | US
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Telephone | 512-328-3947
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Fax |
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Provider Business Mailing Address
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Address Line | 2520 LONGVIEW ST SUITE 302
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City | AUSTIN
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State | TX
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Zip | 78705-4250
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Country | US
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Telephone | 512-328-3947
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 23515
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License Number State | TX
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