| NPI | 1659346690 |
|---|---|
| Former Name | VICKI JAYME LUNDIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LAC11705) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ RN030323) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2007-07-08 |