Individual
CAROLE M NIENABER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 RIVERSIDE AVE, F196, MINNEAPOLIS, MN 55454-1512
(612) 672-2130
Mailing address
29536 147TH ST NW, ZIMMERMAN, MN 55398-8619
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1337
MN
Other
Enumeration date
06/21/2006
Last updated
07/08/2007
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