Organization
STEPHANIE UNTIEDT, PHD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE ANN UNTIEDT PHD (PSCYHOLOGIST)
(763) 595-7294
Entity
Organization
Contact information
Practice address
5101 OLSON MEMORIAL HWY STE 4007, GOLDEN VALLEY, MN 55422-5164
(763) 595-7294
(763) 595-7293
Mailing address
5101 OLSON MEMORIAL HWY STE 4007, GOLDEN VALLEY, MN 55422-5164
(763) 595-7294
(763) 595-7293
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4599
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093756041
—
MN
Enumeration date
02/01/2015
Last updated
02/01/2015
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