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Individual

JOHANNA LEE LAMM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D, L.P.

Contact information

Practice address
11812 WAYZATA BLVD, SUITE 212, MINNETONKA, MN 55305-2012
(612) 708-8100
(612) 337-7638
Mailing address
10640 48TH AVE N, PLYMOUTH, MN 55442-2560
(763) 553-4008
(612) 337-7638

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 4568
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
311S8LA
BLUE CROSS BLUE SHIELD
MN
01
82942337-00
UNITED BEHAVIORAL HEALTH
MN
01
HP52699
HEALTHPARTNERS
MN
Enumeration date
08/30/2006
Last updated
07/08/2007
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