Provider Demographics
NPI:1386906972
Name:DUNLOP, TERRY L (MS, PLMHP)
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:L
Last Name:DUNLOP
Suffix:
Gender:M
Credentials:MS, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:118 N. 5TH ST.
Mailing Address - Street 2:P.O. BOX 147
Mailing Address - City:O'NEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763
Mailing Address - Country:US
Mailing Address - Phone:402-336-4841
Mailing Address - Fax:402-336-4640
Practice Address - Street 1:2315 W. 39TH ST.
Practice Address - Street 2:SUITE 109
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845
Practice Address - Country:US
Practice Address - Phone:308-830-0612
Practice Address - Fax:308-237-0720
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025001700Medicaid