Provider Demographics
NPI:1174913461
Name:LUNDEN, JUDY CAROL (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:CAROL
Last Name:LUNDEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9160 OAKHURST RD
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776-2157
Mailing Address - Country:US
Mailing Address - Phone:727-240-1922
Mailing Address - Fax:727-240-1928
Practice Address - Street 1:9160 OAKHURST RD
Practice Address - Street 2:SUITE 3B
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33776-2157
Practice Address - Country:US
Practice Address - Phone:727-240-1922
Practice Address - Fax:727-240-1928
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9206103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist