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General NPI Number Information
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NPI Number | 1992292445
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Entity Type | Individual
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Provider Name | MADELINE DUNLAP
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Gender | Female
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 2496 DEVOTION RIDGE DR
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City | HENDERSON
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State | NV
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Zip | 89052-5655
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Country | US
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Telephone | 501-258-1983
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Fax |
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Provider Business Mailing Address
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Address Line | 4813 SHOAL CREEK DR
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City | BENTON
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State | AR
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Zip | 72019-6826
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Country | US
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Telephone | 501-258-1983
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 16-0752
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR3260
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License Number State | AR
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