Healthcare Provider Details

I. General information

NPI: 1184551335
Provider Name (Legal Business Name): MAURITA CHRISTENSEN PHD, LP, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 6TH AVE W
SHAKOPEE MN
55379-2213
US

IV. Provider business mailing address

1010 6TH AVE W
SHAKOPEE MN
55379-2213
US

V. Phone/Fax

Practice location:
  • Phone: 952-496-4914
  • Fax:
Mailing address:
  • Phone: 952-496-4914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7210
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: