Individual
CECELIA JOHNSON-DUNLAP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
119 COULTER AVE, SUITES 145-155, ARDMORE, PA 19003-2427
(610) 642-2923
Mailing address
PO BOX 3, HAVERFORD, PA 19041-0003
(610) 642-2923
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OS009838L
PA
2084P0800X
Psychiatry Physician
Primary
OS009838L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1766435
—
PA
Enumeration date
02/05/2007
Last updated
01/17/2008
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