Dr. Stephanie Ann Untiedt
Clinical Psychologist Counseling Psychologist
4343 Abbott Ave S
Minneapolis
, Minnesota 55410-1442
Dr. Stephanie Ann Untiedt
Clinical Psychologist Counseling Psychologist
4343 Abbott Ave S
Minneapolis
, Minnesota 55410-1442
(612) 206-1465
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About
Features
Specialties
- Clinical Psychologist
- Counseling Psychologist
Languages spoken
- English
Location
First Address
- Dr. Stephanie Ann Untiedt
- 4343 Abbott Ave S
- Minneapolis, MN
- Zip : 55410-1442
- Phone : (612) 206-1465
Second Address
- Dr. Stephanie Ann Untiedt
- 4343 Abbott Ave S
- Minneapolis, MN
- Zip : 55410-1442
- Phone : (612) 206-1465
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103G00000X | Clinical Psychologist | 4599 | MN |
| N | 103TC0700X | Clinical Psychologist | 4599 | MN |
| Y | 103TC1900X | Counseling Psychologist | 4599 | MN |
National Provider Identifier
| NPI | 1093756041 |
|---|---|
| Provider Name | Dr. Stephanie Ann Untiedt |
| First Address | Minneapolis, MN 55410-1442 |
| Second Address | Minneapolis, MN 55410-1442 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/06/2006 |
| Last Update Date | 01/02/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 385486800 | (05) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.