Healthcare Provider Details

I. General information

NPI: 1407066558
Provider Name (Legal Business Name): AUNDI MARIE HAMMER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 NICOLLET AVE
MINNEAPOLIS MN
55404-3461
US

IV. Provider business mailing address

2430 NICOLLET AVE. S.
MINNEAPOLIS MN
55404
US

V. Phone/Fax

Practice location:
  • Phone: 612-871-1454
  • Fax: 612-871-1505
Mailing address:
  • Phone: 612-871-1454
  • Fax: 612-871-1505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1716
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: