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Individual

MARY J DUNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
1885 UNIVERSITY AVE W, SUITE 246, SAINT PAUL, MN 55104-3489
(612) 326-7571
(651) 647-9147
Mailing address
1885 UNIVERSITY AVE W, SUITE 246, SAINT PAUL, MN 55104-3489
(612) 326-7571

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301125
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
57422KU
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
11/03/2008
Last updated
04/14/2011
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