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403 Center Ave Ste 410 Moorhead MN 56560-1975 | |
| (218) 227-0338 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 403 Center Ave, Moorhead, Minnesota |
| Authorized Official Name and Position | Linda R Hamann (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2182270338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
403 Center Ave Ste 410 Moorhead MN 56560-1975 Ph: (218) 227-0338 | 403 Center Ave Ste 410 Moorhead MN 56560-1975 Ph: (218) 227-0338 |
| NPI Number | 1194913798 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 07/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194913798 | NPI | - | NPPES |
| 18311 | Medicaid | ND | |
| 481216600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP 3183 (Minnesota) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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