institution
Northern Waters Clinic, Pllc
Mental Health Clinic/Center (Including Community Mental Health Center) in Hermantown, Minnesota
NPI 1316445455

Northern Waters Clinic, Pllc is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Duluth, MN and is specialized in Mental Health (Including Community Mental Health Center). Northern Waters Clinic, Pllc practices in Hermantown, MN. The NPI Number for Northern Waters Clinic, Pllc is 1316445455 and holds a License No. 2318 (Minnesota).

The current practice location address for Northern Waters Clinic, Pllc is 4899 Miller Trunk Hwy Ste 208, Hermantown, MN and can be reached out via phone at 218-391-9860 and via fax at 218-391-9860.

Location: 4899 Miller Trunk Hwy Ste 208, Hermantown, MN, 55811-4443
institution
Provider Profile Details
NPI Number
1316445455
Provider Name
Northern Waters Clinic, Pllc
Credential
Provider Entity Type
Organization
Address
4899 Miller Trunk Hwy Ste 208, Hermantown, MN, 55811-4443
Phone Number
218-391-9860
Fax Number
218-391-9860
Provider Enumeration Date
01/23/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1295014520 05 MN
institution
Provider Business Practice Location Address Details
Address
4899 Miller Trunk Hwy Ste 208
City
State
Zip
55811-1582
Phone Number
218-391-9860
Fax Number
218-391-9860
person
Provider Business Mailing Address Details
Address
4899 Miller Trunk Hwy Ste 208
City
State
Zip
55811-1582
Phone Number
218-391-9860
Fax Number
218-391-9860
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health, Child & Adolescent
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
2318 (Minnesota)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
2318 (Minnesota)
Definition
Definition to come...
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