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Individual

RAQUEL R LUNDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2020 N COUNCIL RD, OKLAHOMA CITY, OK 73127-1142
(903) 328-8087
Mailing address
5105 NW 19TH ST, OKLAHOMA CITY, OK 73127-2707
(903) 328-8087

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
27-0255792
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200489380A
OK
Enumeration date
09/16/2013
Last updated
09/16/2013
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