Individual
MS. AUDREY PATRICIA WARRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LP & LMFT
Contact information
Practice address
2006 FIRST AVE N, SUITE B10, ANOKA, MN 55303-2255
(763) 422-8135
(763) 422-1943
Mailing address
2006 FIRST AVE N, SUITE B10, ANOKA, MN 55303-2255
(763) 422-8135
(763) 422-1943
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0165
MN
106H00000X
Marriage & Family Therapist
LMFT0754
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00021
—
MN
01
—
00720
BCBS PIN NO
—
01
—
53193727
UBH ONLINE USER NO
—
05
—
535248700
—
MN
01
—
6264783
MEDICA
—
01
—
6C494WA
BCBS GROUP NO
—
01
—
6C49SWA
BCBS ID NO
—
Enumeration date
01/30/2007
Last updated
06/20/2013
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