Provider Demographics
NPI:1336248053
Name:HOLIDAY-LYNCH, NINA A (LP)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:A
Last Name:HOLIDAY-LYNCH
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4360 BROOKSIDE CT
Mailing Address - Street 2:201
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-1468
Mailing Address - Country:US
Mailing Address - Phone:952-947-0834
Mailing Address - Fax:
Practice Address - Street 1:4432 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3519
Practice Address - Country:US
Practice Address - Phone:612-871-0118
Practice Address - Fax:612-870-2403
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3584103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist