Doctor Name: | SANDRA MAGNUSON |
NPI Number: | 1013079300 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 3467-123 |
Business Practice Address: | 220 Washington Ave Oshkosh, WI - 549015030 |
Business Phone Number: | 9202364600 |
Business Fax Number: | |
Mailing Address: | Po Box 2187, OSHKOSH |
State: | WI |
Postal Code: | 549032187 |
Phone Number: | 9202364600 |
Fax Number: | |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3467-123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |