Provider Demographics
NPI:1053756684
Name:DUNN, ASHLI-JEAN (LCSW, RBT)
Entity type:Individual
Prefix:
First Name:ASHLI-JEAN
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:LCSW, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 BEAL PKWY NW
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-3917
Mailing Address - Country:US
Mailing Address - Phone:850-744-0118
Mailing Address - Fax:
Practice Address - Street 1:2242 NW 39TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8884
Practice Address - Country:US
Practice Address - Phone:405-602-3171
Practice Address - Fax:405-602-3226
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
RBT-22-199476106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical