1265802367 NPI number — MRS. DIANA LYNNE DUNN LPCC, ATR

Table of content: MRS. DIANA LYNNE DUNN LPCC, ATR (NPI 1265802367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265802367 NPI number — MRS. DIANA LYNNE DUNN LPCC, ATR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUNN
Provider First Name:
DIANA
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPCC, ATR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
REITZ
Provider Other First Name:
DIANA
Provider Other Middle Name:
LYNNE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPCC, ATR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265802367
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 AKRON GENERAL AVE
Provider Second Line Business Mailing Address:
INTENSIVE OUTPATIENT PROGRAM
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44307-2432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-344-7042
Provider Business Mailing Address Fax Number:
330-344-5802

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 AKRON GENERAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44307-2432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-344-1559
Provider Business Practice Location Address Fax Number:
330-344-5802
Provider Enumeration Date:
10/01/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  E.0600603 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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