| Doctor Name: | DR. LUANN MARIEDA KLINDWORTH |
| NPI Number: | 1174560932 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D, LP |
| License Number: | LP4039 |
| Business Practice Address: | 217 Plum St # 140 Box 8a Red Wing, MN - 550662351 |
| Business Phone Number: | 6512120851 |
| Business Fax Number: | 6513859052 |
| Mailing Address: | 217 Plum St # 140, Box 8a RED WING |
| State: | MN |
| Postal Code: | 550662351 |
| Phone Number: | 6512120851 |
| Fax Number: | 6513859052 |
| NPI Enumeration Date: | 06/01/2006 |
| NPI Last Update Date: | 04/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TM1800X |
| License Number: | LP4039 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Mental Retardation & Developmental Disabilities |
| Taxonomy Definition: | |