Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | LP6407 | MN |
NPI | 1033446331 |
---|---|
Provider Name | Denae R Kuenzel |
First Address | Saint Cloud, MN 56303-2613 |
Second Address | Elk River, MN 55330-1581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2009 |
Last Update Date | 04/06/2019 |