Provider Demographics
NPI:1154621944
Name:DUNNUCK, SANDRA LYNNE (LPC-S, PSOTP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LYNNE
Last Name:DUNNUCK
Suffix:
Gender:F
Credentials:LPC-S, PSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 GREEN FIELD PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3929
Mailing Address - Country:US
Mailing Address - Phone:281-793-1452
Mailing Address - Fax:936-538-3278
Practice Address - Street 1:13 GREEN FIELD PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3929
Practice Address - Country:US
Practice Address - Phone:281-793-1452
Practice Address - Fax:936-538-3278
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20118101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20118OtherLPC-S LICENSE #