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General NPI Number Information
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NPI Number | 1720558919
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Entity Type | Individual
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Provider Name | MANXUAN WU
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Gender | Female
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 8200 HUMBOLDT AVE S STE 306
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1453
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Country | US
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Telephone | 952-454-0421
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Fax |
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Provider Business Mailing Address
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Address Line | 1420 6TH ST SE
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-1506
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Country | US
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Telephone | 612-707-1573
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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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