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NPI Code Detail

MEDICARE: DR. LINDSAY ALLYN YATES PLUMER PH.D.

MEDICARE: DR. LINDSAY ALLYN YATES PLUMER PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistLP6308MN
2390200000XStudent in an Organized Health Care Education/Training Program
3103TC0700XClinical PsychologistLP3608MN

General Provider Information

NPI Number : 1023564887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDSAY ALLYN YATES PLUMER PH.D.
Provider Business Mailing Address
First Line : 712 HORACE AVE N
Second Line :
City : THIEF RIVER FALLS
State : MN
Zip : 56701-1626
Country : US
Telephone Number : 203-207-1940
Fax Number :
Provider Business Practice Location Address
First Line : 112 1ST ST W
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-4002
Country : US
Telephone Number : 218-888-8032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2016
Last Update Date : 09/28/2022

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