Provider Demographics
NPI:1952881807
Name:GUNN, LINDY MILLER (ECSE)
Entity Type:Individual
Prefix:MRS
First Name:LINDY
Middle Name:MILLER
Last Name:GUNN
Suffix:
Gender:F
Credentials:ECSE
Other - Prefix:MISS
Other - First Name:LINDY
Other - Middle Name:MILLER
Other - Last Name:CARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3762 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3622
Mailing Address - Country:US
Mailing Address - Phone:251-689-4962
Mailing Address - Fax:
Practice Address - Street 1:3762 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3622
Practice Address - Country:US
Practice Address - Phone:251-689-4962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO241009252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency