Provider Demographics
NPI:1942639216
Name:LUNDY, MEGHAN (MS, LCGC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:LUNDY
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11143 PARKVIEW PLAZA DR
Mailing Address - Street 2:STE. 311
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1727
Mailing Address - Country:US
Mailing Address - Phone:260-482-3886
Mailing Address - Fax:260-482-1910
Practice Address - Street 1:11143 PARKVIEW PLAZA DR
Practice Address - Street 2:STE. 311
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-1727
Practice Address - Country:US
Practice Address - Phone:260-482-3886
Practice Address - Fax:260-482-1910
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN74000064A170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS