Provider Demographics
NPI:1487811105
Name:NUVIEW PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:NUVIEW PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONAE
Authorized Official - Middle Name:VERBENA
Authorized Official - Last Name:GUSTAFSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D,LP
Authorized Official - Phone:651-430-0888
Mailing Address - Street 1:6120 OREN AVE N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6155
Mailing Address - Country:US
Mailing Address - Phone:651-430-0888
Mailing Address - Fax:651-430-0889
Practice Address - Street 1:6120 OREN AVE N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6155
Practice Address - Country:US
Practice Address - Phone:651-430-0888
Practice Address - Fax:651-430-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3566103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty