Organization
CENTER FOR MINDFUL DIALOGUE, PA
Active
Organization
CENTER FOR MINDFUL DIALOGUE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA SUSAN COHEN PH.D. (PRESIDENT)
(612) 379-5360
Entity
Organization
Contact information
Practice address
416 E HENNEPIN AVE, SUITE 107, MINNEAPOLIS, MN 55414-1006
(612) 379-5360
(612) 379-5353
Mailing address
416 E HENNEPIN AVE, SUITE 107, MINNEAPOLIS, MN 55414-1006
(612) 379-5360
(612) 379-5353
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1749
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02849CO
BLUECROSSBLUESHIELD
MN
Enumeration date
05/03/2007
Last updated
08/22/2020
Update your record
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