Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5965 | CT |
NPI | 1013312206 |
---|---|
Provider Name | Lynda R. Dunlop |
First Address | Windsor, CT 06095-1722 |
Second Address | Manchester, CT 06040-3926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2014 |
Last Update Date | 16/03/2017 |