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General NPI Number Information
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NPI Number | 1265311666
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Entity Type | Individual
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Provider Name | AMY RUNDELL
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Gender | Female
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 148 FLUTTERMILL LOOP
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City | LIBERTY HILL
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State | TX
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Zip | 78642-2271
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Country | US
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Telephone | 512-576-7731
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Fax |
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Provider Business Mailing Address
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Address Line | 148 FLUTTERMILL LOOP
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City | LIBERTY HILL
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State | TX
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Zip | 78642-2271
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Country | US
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Telephone | 512-576-7731
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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