Individual
COLLEEN M DANIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
8675 VALLEY CREEK RD, WOODBURY, MN 55125-2337
(651) 501-3000
(651) 501-3500
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4191
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3532
MN
103TC0700X
Clinical Psychologist
102235
MN
103TC0700X
Clinical Psychologist
LP3532
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
486518900
—
MN
Enumeration date
04/04/2006
Last updated
05/22/2023
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