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NPI Code Detail

MEDICARE: JOAN CHRISTENSEN MA, LPP

MEDICARE:   JOAN  CHRISTENSEN  MA, LPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistLPP0019MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
161 00304OTHERMNUNITED BEHAVIORAL HEALTH
21012334OTHERMNPREFERRED ONE
301H88CHOTHERMNBCBS OF MINNESOTA

General Provider Information

NPI Number : 1588877195
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN CHRISTENSEN MA, LPP
Provider Business Mailing Address
First Line : 1404 HIGHWAY 71
Second Line :
City : INTERNATIONAL FALLS
State : MN
Zip : 56649-2154
Country : US
Telephone Number : 218-283-3406
Fax Number :
Provider Business Practice Location Address
First Line : 1404 HIGHWAY 71
Second Line :
City : INTERNATIONAL FALLS
State : MN
Zip : 56649-2154
Country : US
Telephone Number : 218-283-3406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 07/08/2007

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Directions to “ JOAN CHRISTENSEN MA, LPP” Practice Location

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