Organization
J M BALDUS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MICHAEL BALDUS PHD, LP (PSYCHOLOGIST)
(763) 913-6292
Entity
Organization
Contact information
Practice address
5200 MAYWOOD RD, MOUND, MN 55364-1775
(763) 913-6292
Mailing address
3032 HIGHVIEW LN, MOUND, MN 55364-9422
(763) 913-6292
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
LP0796
MN
261QM0855X
Adolescent and Children Mental Health Clinic/Center
LP0796
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6500552000
—
MN
Enumeration date
07/15/2013
Last updated
07/15/2013
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