Individual
MRS. JEAN KAY LUNDHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
215 N 2ND ST, SUITE 101, RIVER FALLS, WI 54022-3706
(715) 425-8899
(715) 425-5590
Mailing address
215 N 2ND ST, SUITE 101, RIVER FALLS, WI 54022-3706
(715) 425-8899
(715) 425-5590
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1695 057
WI
103T00000X
Psychologist
LP1360
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08631LU
BLUE CROSS MN
—
01
—
366502
PREFERRED ONE
—
05
—
39263900
—
WI
Enumeration date
06/29/2006
Last updated
07/08/2007
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