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NPI Code Detail

MEDICARE: AMANDA DUNN LPC-A

MEDICARE: AMANDA DUNN LPC-A
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
1101YP2500XProfessional Counselor95839TX

General Provider Information

NPI Number : 1679307854
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA DUNN LPC-A
Provider Business Mailing Address
First Line : 717 SCENIC HILL DRIVE
Second Line : APT 717
City : FORT WORTH
State : TX
Zip : 76111
Country : US
Telephone Number : 575-441-1700
Fax Number :
Provider Business Practice Location Address
First Line : 905 W CANTEY ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-3205
Country : US
Telephone Number : 817-382-1876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2024
Last Update Date : 08/29/2024

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Directions to “ AMANDA DUNN LPC-A” Practice Location

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