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General NPI Number Information
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NPI Number | 1952190514
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Entity Type | Organization
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Legal Business Name | HEATHER K DUNNAM LCSW PLLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1317 W JEFFERSON ST
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City | BOISE
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State | ID
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Zip | 83702-5320
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Country | US
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Telephone | 208-863-4683
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Fax |
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Provider Business Mailing Address
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Address Line | 1903 S ROOSEVELT ST
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City | BOISE
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State | ID
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Zip | 83705-3259
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Country | US
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Telephone | 298-863-4682
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER K DUNNAM
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Credential | LCSW
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Telephone | 208-863-4682
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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 |
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