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General NPI Number Information
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NPI Number | 1366273823
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR INTEGRATIVE HEALTH LLC
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 10237 GRAND VALLEY LN
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City | WOODBURY
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State | MN
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Zip | 55129-4253
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Country | US
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Telephone | 612-470-0240
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Fax |
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Provider Business Mailing Address
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Address Line | 10237 GRAND VALLEY LN
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City | WOODBURY
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State | MN
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Zip | 55129-4253
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Country | US
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Telephone | 612-470-0240
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Fax |
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Authorized Official
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Title or Position | CEO, PSYCOTHERAPIST, HEALTH COACH
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Name | DR. CRYSTAL JUNDT
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Credential | DMFT, LMFT
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Telephone | 612-470-0240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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