Provider Demographics
NPI:1366053019
Name:DUNAKIN, LESLEY L
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:L
Last Name:DUNAKIN
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 1:5 PARK ST STE 3C
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-1169
Mailing Address - Country:US
Mailing Address - Phone:802-598-5607
Mailing Address - Fax:
Practice Address - Street 1:5 PARK ST STE 3C
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1169
Practice Address - Country:US
Practice Address - Phone:802-598-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0057620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health