MEDICARE: DR. AMBER MARTINA LINDEMAN PSYD, LP

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
1	103TC0700X	Clinical Psychologist	LP4882	MN

General Provider Information

NPI Number	:	1841510567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBER MARTINA LINDEMAN PSYD, LP

Provider Business Mailing Address
First Line	:	PO BOX 681
Second Line	:
City	:	SOUTH ST PAUL
State	:	MN
Zip	:	55075-0681
Country	:	US
Telephone Number	:	651-283-5881
Fax Number	:

Provider Business Practice Location Address
First Line	:	2245 JEWEL LN
Second Line	:
City	:	SOUTH ST PAUL
State	:	MN
Zip	:	55075
Country	:	US
Telephone Number	:	651-283-5881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	07/30/2018

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