Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 2010023850 | MO |
NPI | 1003012048 |
---|---|
Provider Name | Ms. Jennifer Marie Dunn |
First Address | Saint Louis, MO 63139-2403 |
Second Address | Saint Louis, MO 63139-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 26/03/2021 |