Healthcare Provider Details

I. General information

NPI: 1639364326
Provider Name (Legal Business Name): CHRISTINE DOOLEY-HARRINGTON LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 02/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8009 34TH AVE S SUITE 1490
BLOOMINGTON MN
55425-1608
US

IV. Provider business mailing address

8009 34TH AVE S SUITE 1490
BLOOMINGTON MN
55425-1608
US

V. Phone/Fax

Practice location:
  • Phone: 651-324-7740
  • Fax:
Mailing address:
  • Phone: 651-324-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17018
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: