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General NPI Number Information
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NPI Number | 1730904061
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Entity Type | Individual
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Provider Name | ANTONIONETTA MARIE DUNLAP RMHC
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Gender | Female
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 4719 HIGHWAY 90
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City | MARIANNA
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State | FL
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Zip | 32446-7839
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Country | US
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Telephone | 850-526-3314
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Fax |
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Provider Business Mailing Address
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Address Line | 4423 HOLLY HILL DR APT C
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City | MARIANNA
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State | FL
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Zip | 32448-8414
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Country | US
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Telephone | 850-633-7372
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | FL
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