Provider Demographics
NPI:1538663083
Name:KUJAWA, LINDSAY F (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:F
Last Name:KUJAWA
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 TECHNOLOGY DR NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5118
Mailing Address - Country:US
Mailing Address - Phone:218-751-0282
Mailing Address - Fax:218-751-0870
Practice Address - Street 1:4225 TECHNOLOGY DR NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5118
Practice Address - Country:US
Practice Address - Phone:218-751-0282
Practice Address - Fax:218-751-0870
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6235103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist