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General NPI Number Information
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NPI Number | 1871682633
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Entity Type | Individual
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Provider Name | WAYNE ALAN DUNN LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12584 DARBY BROOK CT
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2485
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Country | US
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Telephone | 703-499-9889
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Fax | 703-499-9889
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Provider Business Mailing Address
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Address Line | PO BOX 492
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City | SPRINGFIELD
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State | VA
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Zip | 22150-0492
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Country | US
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Telephone | 571-201-2737
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904006252
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50077750
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License Number State | DC
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