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DR. ERIC JOHN LUND PSY.D, BCBA-D, AND A

Behavioral Analyst

Green Bay, Wisconsin

Provider NPI: 1801954474

Provider Information:
DR. ERIC JOHN LUND PSY.D, BCBA-D, AND A
Gender: M
Not Sole Proprietor

Practice Location:
1575 ALLOUEZ AVE  GREEN BAY, WI 54311 US
Tel: 920-857-9041  Fax: 920-857-3366

Business Mailing Address:
1575 ALLOUEZ AVE  GREEN BAY, WI 54311 US
Tel: 920-857-9041  Fax: 920-857-3366

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
Clinical
WI1871057
N103K00000X
WI1-08-4429

Other Provider Identifiers:

IssuerNumberStateType
1801954474WI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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