Healthcare Provider Details

I. General information

NPI: 1679048227
Provider Name (Legal Business Name): MARGUERITE OHRTMAN ED.D, LPCC, NCC, ACS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7825 WASHINGTON AVE S STE 500
MINNEAPOLIS MN
55439-2415
US

IV. Provider business mailing address

14195 56TH AVE N
PLYMOUTH MN
55446-3036
US

V. Phone/Fax

Practice location:
  • Phone: 515-450-7476
  • Fax:
Mailing address:
  • Phone: 515-450-7476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1430
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: