Individual
JUDY D SIEMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LADC
Contact information
Practice address
1615 ARCHWOOD RD, MINNETONKA, MN 55305
(612) 998-6640
Mailing address
1615 ARCHWOOD RD, MINNETONKA, MN 55305-2149
(612) 998-6640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
300804
MN
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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