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General NPI Number Information
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NPI Number | 1538032123
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Entity Type | Individual
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Provider Name | MS. NINA ANNE BOGUSLAWSKI
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Gender | Female
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 6595 EDENVALE BLVD STE 155
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City | EDEN PRAIRIE
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State | MN
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Zip | 55346-2511
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Country | US
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Telephone | 612-816-8081
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Fax |
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Provider Business Mailing Address
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Address Line | 7920 MINNETONKA BLVD APT 332
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-3093
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Country | US
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Telephone | 952-688-8142
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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