Provider Demographics
NPI:1063598126
Name:DUNN, ALEXANDRA HABERLE
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:HABERLE
Last Name:DUNN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:DAUVERGNE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:11 BLUEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02653-3487
Mailing Address - Country:US
Mailing Address - Phone:508-255-5695
Mailing Address - Fax:
Practice Address - Street 1:11 BLUEBERRY LN
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653-3487
Practice Address - Country:US
Practice Address - Phone:508-255-5695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10224861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical