Individual
LYNETTE CAROL IMDIEKE-STRUZYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPCC
Contact information
Practice address
6069 HIDDEN LN, SOUTH HAVEN, MN 55382-4505
(320) 255-9188
Mailing address
6069 HIDDEN LN, SOUTH HAVEN, MN 55382-4505
(320) 255-9188
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CC00183
MN
101YM0800X
Mental Health Counselor
Primary
CC00183
MN
101YP2500X
Professional Counselor
CC00183
MN
103TC1900X
Counseling Psychologist
CC00183
MN
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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