Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 12947 | MN |
Y | 103T00000X | Psychologist | 12947 | MN |
NPI | 1003959347 |
---|---|
Provider Name | Linda M Tunell |
First Address | Lakeville, MN 55044 |
Second Address | Lakeville, MN 55044-8348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 26/10/2017 |