Individual
DAN W MARQUARDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSLP
Contact information
Practice address
617 OAK ST, BRAINERD, MN 56401-3610
(218) 829-7140
Mailing address
617 OAK ST, BRAINERD, MN 56401-3610
(218) 829-7140
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4659
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84G65MA
BCBS
MN
Enumeration date
07/28/2006
Last updated
07/09/2007
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