Provider Demographics
NPI:1265311666
Name:RUNDELL, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:RUNDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 FLUTTERMILL LOOP
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-2271
Mailing Address - Country:US
Mailing Address - Phone:512-576-7731
Mailing Address - Fax:
Practice Address - Street 1:148 FLUTTERMILL LOOP
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642-2271
Practice Address - Country:US
Practice Address - Phone:512-576-7731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty