MEDICARE: MS. JUANITA DUNBAR M.A., 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	013870	NY

General Provider Information

NPI Number	:	1366697633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUANITA DUNBAR M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	2518 FREDERICK DOUGLASS BLVD
Second Line	:	APT. 3F
City	:	NEW YORK
State	:	NY
Zip	:	10030-2701
Country	:	US
Telephone Number	:	917-941-3343
Fax Number	:

Provider Business Practice Location Address
First Line	:	2518 FREDERICK DOUGLASS BLVD
Second Line	:	APT. 3F
City	:	NEW YORK
State	:	NY
Zip	:	10030-2701
Country	:	US
Telephone Number	:	917-941-3343
Fax Number	:

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

Provider Enumeration Date	:	11/29/2008
Last Update Date	:	11/29/2008

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Directions to “ MS. JUANITA DUNBAR M.A., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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