Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY003049 | GA |
N | 103TC0700X | Clinical Psychologist | PSY003049 | GA |
N | 102L00000X | Psychologist | PSY003049 | GA |
N | 103T00000X | Psychologist | PSY003049 | GA |
Y | 103G00000X | Clinical Psychologist | 51 889 | MS |
Y | 103TC0700X | Clinical Psychologist | 51 889 | MS |
N | 103G00000X | Clinical Psychologist | PSY003049 | GA |
N | 103TC0700X | Clinical Psychologist | PSY003049 | GA |
N | 103TR0400X | Rehabilitation Psychologist | PSY003049 | GA |
NPI | 1598823809 |
---|---|
Provider Name | Dr. Karen Lundin |
First Address | Gulfport, MS 39503-3485 |
Second Address | Gulfport, MS 39503-3485 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 01/06/2012 |