Organization
CARA LUNDEEN PSYD LP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARA LUNDEEN PSYD LP (OWNER)
(651) 645-5885
Entity
Organization
Contact information
Practice address
821 RAYMOND AVE STE 140, SAINT PAUL, MN 55114-1509
(651) 645-5885
(651) 645-1403
Mailing address
821 RAYMOND AVE STE 140, SAINT PAUL, MN 55114-1509
(651) 645-5885
(651) 645-1403
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4511
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
522410100
—
MN
01
—
89G22LU
BLUE CROSS BLUE SHEILD OF MN
MN
Enumeration date
10/05/2006
Last updated
07/31/2008
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