| Organization Name: | LYNN WORKMAN NODLAND, PH.D. & ASSOCIATES, INC |
| NPI Number: | 1295180040 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LYNN WORKMAN NODLAND (CEO) |
| Mailing Address: | 684 Excelsior Blvd Ste 120 Excelsior |
| State: | MN US |
| Postal Code: | 553311981 |
| Phone Number: | 9524522664 |
| Fax Number: | |
| NPI Enumeration Date: | 04/29/2016 |
| NPI Last Update Date: | 04/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP2607 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |