Individual
CHARLOTTE MAE GERTH HAANEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
2805 CLIFF RD E, BURNSVILLE, MN 55337-4095
(612) 203-9156
Mailing address
1671 CANYON LN, NEW BRIGHTON, MN 55112-7240
(612) 203-9156
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4832
MN
Other
Enumeration date
10/17/2020
Last updated
10/17/2020
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