Provider Demographics
NPI:1336478833
Name:BUNDY, ATTICIA PARMER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ATTICIA
Middle Name:PARMER
Last Name:BUNDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ATTICIA
Other - Middle Name:BUNDY
Other - Last Name:MCATEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1891 CUDE RD
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:NC
Mailing Address - Zip Code:27235-9701
Mailing Address - Country:US
Mailing Address - Phone:336-272-8090
Mailing Address - Fax:
Practice Address - Street 1:806 GREEN VALLEY RD
Practice Address - Street 2:SUITE 301
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7042
Practice Address - Country:US
Practice Address - Phone:336-379-0199
Practice Address - Fax:336-574-1139
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health