Healthcare Provider Details

I. General information

NPI: 1235929902
Provider Name (Legal Business Name): DAVID NOER VRAZA LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DAVID NOER WRASE

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 WAYZATA BLVD STE 340
GOLDEN VALLEY MN
55426-1365
US

IV. Provider business mailing address

8401 WAYZATA BLVD STE 340
GOLDEN VALLEY MN
55426-1365
US

V. Phone/Fax

Practice location:
  • Phone: 763-566-0088
  • Fax: 763-566-0089
Mailing address:
  • Phone: 763-566-0088
  • Fax: 763-566-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4959
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: