Individual
DR. NAOMI NYSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
PSYCHOLOGY - BUILDING A, 3301 7TH AVE. N., ANOKA, MN 55303
(651) 242-8330
Mailing address
PSYCHOLOGY - BUILDING A, 3301 7TH AVE. N., ANOKA, MN 55303
(651) 242-8330
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP6316
MN
103TC0700X
Clinical Psychologist
LP6316
MN
Other
Enumeration date
04/29/2020
Last updated
09/06/2022
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