Individual
MANIJEH DANESHPOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7382 KIRKWOOD CT, MAPLE GROVE, MN 55369-5270
(763) 391-2209
Mailing address
7382 KIRKWOOD CT, MAPLE GROVE, MN 55369-5270
(763) 391-2209
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT #865
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111589
UCARE
MN
01
—
3051108
HEALTH PARTNERS
MN
01
—
6141657
MEDICA
MN
01
—
64G53DA
BLUE CROSS BLUE SHIELD MN
MN
01
—
990991013908
PREFERRED ONE
MN
Enumeration date
05/15/2007
Last updated
07/08/2007
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