Individual
MICHELLE DUNHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
726 SOUTH BLVD APT 6, LAKELAND, FL 33801-5589
(863) 286-7826
Mailing address
726 SOUTH BLVD APT 6, LAKELAND, FL 33801-5589
(863) 286-7826
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CW-0047842014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002379300
—
FL
Enumeration date
10/31/2014
Last updated
10/31/2014
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