Provider Demographics
NPI:1619949153
Name:KUNDE, MARY K (PHD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:KUNDE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1001 E 21ST ST
Practice Address - Street 2:STE. 100
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1033
Practice Address - Country:US
Practice Address - Phone:605-322-7580
Practice Address - Fax:605-322-7579
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD304103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD32268OtherSANFORD HEALTH PLAN
SDP304OtherDAKOTACARE
MN48D55KUOtherCC SYSTEMS/ BLUE PLUS
IA3148379Medicaid
SD6551142Medicaid
SD769191019126OtherPREFERRED ONE
SD0007694OtherBLUE CROSS
ND12242Medicaid
SD25453OtherARAZ/ AMERICA'S PPO
SD57108D005OtherWPS TRICARE
MN92411422904OtherPRIMEWEST
MN151765OtherUCARE
SDHP24356OtherHEALTHPARTNERS
SD15191OtherMIDLANDS CHOICE
NE46022474340Medicaid
SD769191019126OtherPREFERRED ONE
NE46022474340Medicaid