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Individual

DAWN GURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
112 MAIN STREET, SUITE #9, PUTNAM, CT 06260
(860) 963-3807
Mailing address
83 PERRY STREET, SUITE #172, PUTNAM, CT 06260
(860) 963-3807

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
000375
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
240000375CT02
ANTHEM BLUE CROSS BLUE SH
01
307498
MHN
01
536259
VALUE OPTIONS
Enumeration date
11/14/2006
Last updated
07/08/2007
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