Provider Demographics
NPI:1326656737
Name:URBACH, LUKAS
Entity Type:Individual
Prefix:
First Name:LUKAS
Middle Name:
Last Name:URBACH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13911 RIDGEDALE DR STE 335
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1775
Mailing Address - Country:US
Mailing Address - Phone:612-875-6416
Mailing Address - Fax:
Practice Address - Street 1:13911 RIDGEDALE DR STE 335
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1775
Practice Address - Country:US
Practice Address - Phone:612-875-6416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst