Provider Demographics
NPI:1538032123
Name:BOGUSLAWSKI, NINA ANNE
Entity type:Individual
Prefix:MS
First Name:NINA
Middle Name:ANNE
Last Name:BOGUSLAWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 MINNETONKA BLVD APT 332
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3093
Mailing Address - Country:US
Mailing Address - Phone:952-688-8142
Mailing Address - Fax:
Practice Address - Street 1:6595 EDENVALE BLVD STE 155
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-2511
Practice Address - Country:US
Practice Address - Phone:612-816-8081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health