Individual
MR. MICHAEL SHAWN OLAUGHLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
510 4TH ST SOUTH, FARGO, ND 58103
(701) 476-7800
Mailing address
830 12TH ST NORTH, BRECKENRIDGE, MN 56520
(218) 643-8714
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3493
MN
103T00000X
Psychologist
Primary
350
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11928
—
ND
Enumeration date
10/02/2006
Last updated
07/08/2007
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