Healthcare Provider Details

I. General information

NPI: 1881345312
Provider Name (Legal Business Name): AMANDA TOEGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CENTRAL AVE N
FARIBAULT MN
55021-5217
US

IV. Provider business mailing address

2575 HARVEST LN
OWATONNA MN
55060-4305
US

V. Phone/Fax

Practice location:
  • Phone: 507-446-0431
  • Fax:
Mailing address:
  • Phone: 507-446-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: