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General NPI Number Information
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NPI Number | 1386351484
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Entity Type | Individual
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Provider Name | RACHEL LYDIA DUNN LGSW
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Gender | Female
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 105 N WEDGE ST STE 3
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City | BRIDGEPORT
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State | WV
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Zip | 26330-2023
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Country | US
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Telephone | 304-241-1766
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Fax | 855-898-5805
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Provider Business Mailing Address
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Address Line | 139 CADET ST
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City | FAIRMONT
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State | WV
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Zip | 26554-2005
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Country | US
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Telephone | 304-290-8962
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | BP00944453
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License Number State | WV
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