Individual
GINA LUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3451 EASTON BLVD, DES MOINES, IA 50317-3214
(515) 262-0349
Mailing address
3451 EASTON BLVD, DES MOINES, IA 50317-3214
(515) 262-0349
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12104
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420946031
—
IA
Enumeration date
11/29/2017
Last updated
11/29/2017
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