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NPI 1407791262

NPI 1407791262 : MARY CLARE DUNAWAY : GULFPORT, MS

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General NPI Number Information
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    NPI Number           |    1407791262
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    Entity Type          |    Individual 
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    Provider Name        |    MARY CLARE DUNAWAY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/20/2026
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    Last Update Date     |    04/20/2026
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Provider Practice Location Address
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    Address Line         |    1800 BEACH DR 
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    City                 |    GULFPORT
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    State                |    MS
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    Zip                  |    39507-1553
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    Country              |    US
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    Telephone            |    228-897-4452
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    Fax                  |    228-897-4481
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Provider Business Mailing Address
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    Address Line         |    42465 HIGHWAY 195 
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    City                 |    HALEYVILLE
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    State                |    AL
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    Zip                  |    35565-7052
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    Country              |    US
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    Telephone            |    256-350-1764
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    4003
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    License Number State |    MS
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