Provider Demographics
NPI:1215329156
Name:PAULSON, NANCY K (LMFT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:K
Last Name:PAULSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CENTRAL AVE N # 431
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-5211
Mailing Address - Country:US
Mailing Address - Phone:507-390-4046
Mailing Address - Fax:507-323-8141
Practice Address - Street 1:122 CENTRAL AVE N
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-5211
Practice Address - Country:US
Practice Address - Phone:507-390-4046
Practice Address - Fax:507-323-8141
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2607106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist