| NPI | 1588993091 |
|---|---|
| Former Legal Business Name | LUND VAN DYKE, LLC |
| Entity Type | Organization |
| Authorized Contact | ERIC JOHN LUND President/Cco 920-857-2577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WI 1-08-4429) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 1871-57) |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2016-01-14 |