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NPI Code Detail

MEDICARE: MS. LINDA JEAN PANTZKE LMFT

MEDICARE: MS. LINDA JEAN PANTZKE LMFT
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
1106H00000XMarriage & Family Therapist1568MN

General Provider Information

NPI Number : 1962537928
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA JEAN PANTZKE LMFT
Provider Business Mailing Address
First Line : 311 15TH ST SW
Second Line :
City : LITTLE FALLS
State : MN
Zip : 56345-5201
Country : US
Telephone Number : 320-632-2678
Fax Number :
Provider Business Practice Location Address
First Line : 1906 5TH AVE SE
Second Line :
City : LITTLE FALLS
State : MN
Zip : 56345-3317
Country : US
Telephone Number : 320-632-6647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 07/09/2007

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Directions to “ MS. LINDA JEAN PANTZKE LMFT” Practice Location

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