Provider Demographics
NPI:1225648793
Name:LUNDIN-ZEMNOVICH, KATIE (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:LUNDIN-ZEMNOVICH
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 POINTE EMERALD LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1487
Mailing Address - Country:US
Mailing Address - Phone:917-406-8884
Mailing Address - Fax:
Practice Address - Street 1:12401 ORANGE DR STE 224
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330-4343
Practice Address - Country:US
Practice Address - Phone:917-406-8884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3048106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist