Organization
MARIKEN WOGSTAD-HANSEN, PHD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIKEN WOGSTAD-HANSEN PHD, LP, RN, CNS (PHD, LP, RN, CNS)
(651) 603-0540
Entity
Organization
Contact information
Practice address
91 SNELLING AVE N, SUITE 230, SAINT PAUL, MN 55104-6753
(651) 603-0540
(651) 603-0541
Mailing address
91 SNELLING AVE N, SUITE 230, SAINT PAUL, MN 55104-6753
(651) 603-0540
(651) 603-0541
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
12/30/2010
Last updated
12/30/2010
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