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Individual

DR. LINDA C GIACOMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
401 GROVELAND AVE, MINNEAPOLIS, MN 55403-3219
(612) 872-1161
(612) 871-7869
Mailing address
401 GROVELAND AVE, MINNEAPOLIS, MN 55403-3219
(612) 872-1161

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP-1767
MN
103TC0700X
Clinical Psychologist
Primary
LP-1767
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP-1767
MN
103TP0814X
Psychoanalysis Psychologist
LP-1767
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47817GI
BLUE CROSS BLUE SHIELD MN
MN
01
61-80064
MEDICA
MN
01
66549
PREFERRED ONE CH PLAN
MN
01
93551
HEALTH PARTNERS
MN
Enumeration date
05/22/2007
Last updated
03/05/2011
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