Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 6453 | MN |
N | 101YP1600X | Pastoral Counselor | 447 | MN |
N | 101YP2500X | Professional Counselor | 00447(LPC) | MN |
N | 104100000X | Social Worker | 6453 | MN |
NPI | 1326097783 |
---|---|
Provider Name | Sandra Lee Andreasen |
First Address | St. Cloud, MN 56303-1901 |
Second Address | St. Cloud, MN 56303-1901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 20/02/2014 |