| Doctor Name: | MS. JEAN LINDA UDESEN |
| NPI Number: | 1417142332 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1485 81st Avenue North East Spring Lake Park, MN - 55432 |
| Business Phone Number: | 7637803036 |
| Business Fax Number: | 7637800784 |
| Mailing Address: | 103 Windsor Lane, NEW BRIGHTON |
| State: | MN |
| Postal Code: | 55112 |
| Phone Number: | 6516312127 |
| Fax Number: | |
| NPI Enumeration Date: | 09/13/2007 |
| NPI Last Update Date: | 09/13/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |