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Individual

MICHAEL DANA PAULSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
891 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 287-4338
(218) 287-5928
Mailing address
891 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 287-4338
(218) 287-5928

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
39
ND
103TC0700X
Clinical Psychologist
Primary
LP0989
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10716
ND
01
16069
BCND
ND
01
67D82PA
BCMN
MN
Enumeration date
08/09/2006
Last updated
06/17/2008
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