Provider Demographics
NPI:1932423092
Name:DUNKLIN, DONNA J (MSW)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:DUNKLIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2005
Mailing Address - Country:US
Mailing Address - Phone:520-795-0300
Mailing Address - Fax:520-795-8206
Practice Address - Street 1:4301 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2005
Practice Address - Country:US
Practice Address - Phone:520-795-0300
Practice Address - Fax:520-795-8206
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 128611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical