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General NPI Number Information
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NPI Number | 1275838781
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Entity Type | Organization
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Legal Business Name | RED RIVER COUNSELING, PLLC
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 403 CENTER AVE SUITE 410
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City | MOORHEAD
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State | MN
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Zip | 56560-1975
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Country | US
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Telephone | 218-227-0338
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Fax | 218-227-0338
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Provider Business Mailing Address
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Address Line | 403 CENTER AVE SUITE 410
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City | MOORHEAD
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State | MN
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Zip | 56560-1975
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Country | US
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Telephone | 218-227-0338
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Fax | 218-227-0338
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Authorized Official
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Title or Position | PRESIDENT
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Name | LINDA R HAMANN
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Credential | MS LP
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Telephone | 218-227-0338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP 3183
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License Number State | MN
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