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General NPI Number Information
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NPI Number | 1861622110
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Entity Type | Organization
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Legal Business Name | PATRICIA RICHARDSON MSW, LICSW, LMFT, LTD
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Dates
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Enumeration Date | 07/21/2009
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 401 DIVISION ST S STE C
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City | NORTHFIELD
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State | MN
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Zip | 55057-2096
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Country | US
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Telephone | 507-645-5644
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Fax | 507-645-9291
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Provider Business Mailing Address
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Address Line | 401 DIVISION ST S STE C
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City | NORTHFIELD
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State | MN
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Zip | 55057-2096
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Country | US
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Telephone | 507-645-5644
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Fax | 507-645-9291
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA ANN RICHARDSON
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Credential | MSW, LICSW, LMFT
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Telephone | 507-645-5644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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