Provider Demographics
NPI:1336829167
Name:DUNN, FRANK RANDALL
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:RANDALL
Last Name:DUNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 BROWNS MILL RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-1417
Mailing Address - Country:US
Mailing Address - Phone:423-631-0432
Mailing Address - Fax:423-631-0284
Practice Address - Street 1:3114 BROWNS MILL RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-1417
Practice Address - Country:US
Practice Address - Phone:423-631-0432
Practice Address - Fax:423-631-0284
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN89501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical