Individual
PAULA JOY DETJEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
706 DIVISION ST S, NORTHFIELD, MN 55057-2427
(507) 581-0430
Mailing address
1000 SUPERIOR DR, NORTHFIELD, MN 55057-4873
(507) 581-0430
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1399
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-3791736-001
AMERICA'S PPO
MN
Enumeration date
07/25/2006
Last updated
07/08/2007
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