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General NPI Number Information
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NPI Number | 1811163025
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Entity Type | Organization
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Legal Business Name | LAURIE A. DUNN, PH.D., LLC
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 348 PRIOR AVE N STE 104
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City | SAINT PAUL
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State | MN
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Zip | 55104-5188
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Country | US
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Telephone | 651-247-8381
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Fax |
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Provider Business Mailing Address
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Address Line | 348 PRIOR AVE N STE 104
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City | SAINT PAUL
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State | MN
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Zip | 55104-5188
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Country | US
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Telephone | 651-247-8381
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST/OWNER
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Name | LAURIE ANN DUNN
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Credential | PH.D.
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Telephone | 651-247-8381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LP0876
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License Number State | MN
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