Doctor Name: | LAURA A D KUNDE |
NPI Number: | 1134412844 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC, LMFT |
License Number: | 301554 |
Business Practice Address: | 1068 Lake St S #109 Forest Lake, MN - 550252639 |
Business Phone Number: | 6519824792 |
Business Fax Number: | 6519826035 |
Mailing Address: | 1068 Lake St S, #109 FOREST LAKE |
State: | MN |
Postal Code: | 550252639 |
Phone Number: | 6519824792 |
Fax Number: | 6519826035 |
NPI Enumeration Date: | 05/27/2011 |
NPI Last Update Date: | 05/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 301554 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |