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General NPI Number Information
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NPI Number | 1508529165
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Entity Type | Individual
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Provider Name | CHRISTY LYNNE LEDUC MA, MS, LAMFT
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Gender | Female
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 600 25TH AVE S STE 102
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4820
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Country | US
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Telephone | 320-406-1600
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Fax | 320-406-1700
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Provider Business Mailing Address
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Address Line | 2747 PARK DR
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1346
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Country | US
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Telephone | 320-248-8004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4088
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License Number State | MN
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