Provider Demographics
NPI:1730756032
Name:GUNDERSON, LINDSEY MARIE (M ED)
Entity type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:MARIE
Last Name:GUNDERSON
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 REMINGTON CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2924
Mailing Address - Country:US
Mailing Address - Phone:405-255-4209
Mailing Address - Fax:
Practice Address - Street 1:5350 S WESTERN AVE STE 734
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-4535
Practice Address - Country:US
Practice Address - Phone:405-474-6446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator