Individual
MS. EILEEN MARY NIEHAUS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS LP
Contact information
Practice address
730 DODGE AVE, SUITE 101, ELK RIVER, MN 55330-2889
(763) 441-3770
(763) 441-9057
Mailing address
1321 13TH ST N, ST CLOUD, MN 56303-2614
(320) 252-5010
(320) 203-1855
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2408
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19629
OPTUM
—
01
—
6200991
MEDICA
—
01
—
69138NI
BLUE CROSS BLUE SHIELD
MN
01
—
922241022561
PREFERRED ONE
MN
01
—
HP25552
HEALTH PARTNERS
—
Enumeration date
06/17/2006
Last updated
07/08/2007
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