Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 084038 | NY |
NPI | 1003215377 |
---|---|
Provider Name | Ms. Courtney Dunn |
First Address | New York, NY 10010-5011 |
Second Address | New York, NY 10010-5011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2014 |
Last Update Date | 02/11/2018 |