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General NPI Number Information
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NPI Number | 1689709511
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Entity Type | Individual
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Provider Name | LINDA M AMUNDSON MFT, LMFT, LSW
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 809 US HIGHWAY 8
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City | ST. CROIX FALLS
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State | WI
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Zip | 54024
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Country | US
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Telephone | 715-483-3544
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Fax | 715-483-3741
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Provider Business Mailing Address
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Address Line | 362 W WISCONSIN AVE
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City | GRANTSBURG
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State | WI
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Zip | 54840-7821
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Country | US
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Telephone | 715-463-2651
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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 | 639-124
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License Number State | WI
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