| Diane Dunn, Llc | |
|
1029 3rd Ave Ste 2 Worthington MN 56187-2399 | |
| (507) 820-1545 | |
| (507) 825-9978 |
| Full Name | Diane Dunn, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1029 3rd Ave Ste 2, Worthington, Minnesota |
| Authorized Official Name and Position | Diane Kaye Dunn (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5078201545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Dunn, Llc Po Box 291 Worthington MN 56187-0291 Ph: (507) 820-1545 | Diane Dunn, Llc 1029 3rd Ave Ste 2 Worthington MN 56187-2399 Ph: (507) 820-1545 |
| NPI Number | 1053955666 |
|---|---|
| Provider Enumeration Date | 11/06/2019 |
| Last Update Date | 12/06/2019 |
| Medicare PECOS PAC ID | 8123452380 |
|---|---|
| Medicare Enrollment ID | O20191220000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053955666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Diane K Dunn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164457594 PECOS PAC ID: 8325215205 Enrollment ID: I20120117000623 |
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