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General NPI Number Information
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NPI Number | 1457093379
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Entity Type | Individual
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Provider Name | ASHLEE MARIE DUNN RADT-I
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Gender | Female
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 1130 CONROY LN STE 100
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City | ROSEVILLE
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State | CA
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Zip | 95661-4154
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Country | US
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Telephone | 916-580-6600
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Fax | 916-580-6639
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Provider Business Mailing Address
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Address Line | 6220 KING ELDER CT
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City | ROCKLIN
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State | CA
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Zip | 95765-5849
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Country | US
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Telephone | 916-770-0831
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1459720322
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License Number State | CA
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