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General NPI Number Information
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NPI Number | 1952205809
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Entity Type | Individual
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Provider Name | CHRISTINA MADISON
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Gender | Female
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 1251 COUNTY ROAD B2 W
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City | ROSEVILLE
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State | MN
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Zip | 55113-3205
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Country | US
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Telephone | 612-718-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 1299 RUGGLES ST
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City | ROSEVILLE
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State | MN
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Zip | 55113-6169
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Country | US
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Telephone | 612-718-4920
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 475429
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License Number State | MN
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