Healthcare Provider Details

I. General information

NPI: 1316911001
Provider Name (Legal Business Name): LYNDA RICHTSMEIER CYR PHD LP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CHICAGO AVE SOUTH CHILDRENS SPECIALTY CLINIC - INTEGRATIVE MEDICINE
MINNEAPOLIS MN
55404
US

IV. Provider business mailing address

2910 CENTRE POINTE DR CHILDRENS HEALTH CARE
ROSEVILLE MN
55113
US

V. Phone/Fax

Practice location:
  • Phone: 612-813-7888
  • Fax: 612-813-7199
Mailing address:
  • Phone: 651-855-2109
  • Fax: 651-855-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberLP3892
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: