Individual
DR. MARIKEN ELLEN WOGSTAD-HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP, RN, CNS
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
LP3116
MN
103TC0700X
Clinical Psychologist
LP3116
MN
103TP2701X
Group Psychotherapy Psychologist
LP3116
MN
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
R0803692
MN
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R0803692
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330L9WO
BLUE CROSS, RN, CNS
MN
01
—
385K0WO
BLUE CROSS, PHD, LP
MN
Enumeration date
03/21/2007
Last updated
09/11/2025
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