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NPI Code Detail

MEDICARE: VERONICA LUNDGREN

MEDICARE: VERONICA LUNDGREN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1477271757
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA LUNDGREN
Provider Business Mailing Address
First Line : 8558 BLACK STAR CIR
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2649
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8558 BLACK STAR CIR
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2649
Country : US
Telephone Number : 240-374-3368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2022
Last Update Date : 03/23/2026

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Directions to “ VERONICA LUNDGREN ” Practice Location

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