MEDICARE: CIARA NAOMI DUNAGAN MA, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1144926098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA NAOMI DUNAGAN MA, CCC-SLP

Provider Business Mailing Address
First Line	:	3515 E CLAY ST APT B
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-8137
Country	:	US
Telephone Number	:	440-941-9463
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 E PARHAM RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-3119
Country	:	US
Telephone Number	:	440-941-9463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	02/02/2023

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