Individual
AMANDA OGDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
324 BROADWAY ST STE 206, ALEXANDRIA, MN 56308-1482
(320) 762-1762
Mailing address
450 22ND AVE NW, GLENWOOD, MN 56334-4547
(612) 325-6707
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC01552
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CC01552
—
MN
Enumeration date
09/08/2017
Last updated
07/31/2019
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