Provider Demographics
NPI:1134832991
Name:RUNDIO, MATTHEW ANDREW (DMIN, MSMFT, LAMFT)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ANDREW
Last Name:RUNDIO
Suffix:
Gender:M
Credentials:DMIN, MSMFT, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4864 E BASELINE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4629
Mailing Address - Country:US
Mailing Address - Phone:480-877-1486
Mailing Address - Fax:
Practice Address - Street 1:4864 E BASELINE RD STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4629
Practice Address - Country:US
Practice Address - Phone:480-877-1486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAMFT-10852106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist