Individual
TRACEY LICHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
310 4TH AVE SOUTH, SUITE 5010, PMB#93151, MINNEAPOLIS, MN 55415-3309
(612) 444-1769
Mailing address
310 4TH AVE SOUTH, SUITE 5010, PMB#93151, MINNEAPOLIS, MN 55415-3309
(612) 444-1769
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP5680
MN
103T00000X
Psychologist
Primary
PS016298
PA
Other
Enumeration date
03/25/2009
Last updated
08/11/2022
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