Individual
MRS. MICHELLE LEE DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
1062 STATE ROUTE 38, OWEGO, NY 13827-3209
(607) 687-8145
(607) 687-6396
Mailing address
3687 WAITS RD, OWEGO, NY 13827-6547
(607) 687-8145
(607) 687-6396
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18532
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02249145
—
NY
Enumeration date
04/17/2017
Last updated
04/17/2017
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