MEDICARE: MS. JULIA A DUNAWAY LCSW, BCD

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	1041C0700X	Clinical Social Worker	11742	TX

General Provider Information

NPI Number	:	1699831347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIA A DUNAWAY LCSW, BCD

Provider Business Mailing Address
First Line	:	517 DUNAWAY LN
Second Line	:
City	:	AZLE
State	:	TX
Zip	:	76020-3207
Country	:	US
Telephone Number	:	817-919-7761
Fax Number	:

Provider Business Practice Location Address
First Line	:	517 DUNAWAY LN
Second Line	:
City	:	AZLE
State	:	TX
Zip	:	76020-3207
Country	:	US
Telephone Number	:	817-919-7761
Fax Number	:

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/08/2007

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