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Individual

MS. JANICE ANNETTE LUNDEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSW

Contact information

Practice address
2275 W BROADWAY ST., SUITE G., IDAHO FALLS, ID 83402-2902
(208) 524-7400
(208) 534-5715
Mailing address
2 VIRGINIA ST, PHENIX CITY, AL 36869-5436
(406) 250-9574

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-41069
ID
1041C0700X
Clinical Social Worker
Primary
008823
GA

Other

Enumeration date
05/27/2006
Last updated
10/16/2023
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