Individual
MS. DIANE KAYE DUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1234 OXFORD ST, WORTHINGTON, MN 56187-1760
(507) 376-9758
Mailing address
PO BOX 802, WORTHINGTON, MN 56187-0802
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13981
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12292632
CAQH
MN
05
—
929697200
—
MN
Enumeration date
07/12/2006
Last updated
12/06/2019
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