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General NPI Number Information
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NPI Number | 1912279019
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Entity Type | Organization
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Legal Business Name | DR. JANICE NADEAU, PA
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 1409 WILLOW ST SUITE 300
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-2269
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Country | US
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Telephone | 612-870-1244
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Fax | 612-870-8077
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Provider Business Mailing Address
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Address Line | 1409 WILLOW ST SUITE 300
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-2269
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Country | US
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Telephone | 612-870-1244
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Fax | 612-870-8077
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DR. JANICE MARIE NADEAU
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Credential | LP
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Telephone | 612-870-1242
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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 | 0787
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2807
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License Number State | MN
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