Provider Demographics
NPI:1053048553
Name:RAVLIJA, DUNJA
Entity type:Individual
Prefix:
First Name:DUNJA
Middle Name:
Last Name:RAVLIJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 WINDSONG TRL
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4751
Mailing Address - Country:US
Mailing Address - Phone:214-235-8651
Mailing Address - Fax:
Practice Address - Street 1:1812 WINDSONG TRL
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4751
Practice Address - Country:US
Practice Address - Phone:214-235-8651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89315OtherLICENSED PROFESSIONAL COUNSELOR ASSOCIATE LICENSE