Provider Demographics
NPI:1760945950
Name:LUNDI, DAPHNEY FARAH (PHD)
Entity Type:Individual
Prefix:
First Name:DAPHNEY
Middle Name:FARAH
Last Name:LUNDI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 BELMONT LN
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-4294
Mailing Address - Country:US
Mailing Address - Phone:954-261-4689
Mailing Address - Fax:
Practice Address - Street 1:300 S PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2673
Practice Address - Country:US
Practice Address - Phone:954-261-4689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-13
Last Update Date:2019-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3422101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional