Individual
THERESA MAKOONS-SOLARZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LP
Contact information
Practice address
911 18TH ST N, SAINT CLOUD, MN 56303-1203
(320) 252-5010
(320) 203-1855
Mailing address
911 18TH ST N, SAINT CLOUD, MN 56303-1203
(320) 650-1660
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3933
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110609C851
UCARE
—
05
—
1134165244
—
MN
01
—
6239970
MEDICA
—
01
—
7H83350
BCBS
—
01
—
922241022572
PREFERRED ONE
—
05
—
934527200
—
MN
01
—
HP25555
HEALTH PARTNERS
—
Enumeration date
06/20/2006
Last updated
07/02/2024
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