Doctor Name: | DR. CAROL COLLETTE FOLLINGSTAD |
NPI Number: | 1023197522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. LP |
License Number: | LP4052 |
Business Practice Address: | 1132 28th Ave S Suite 102 Moorhead, MN - 565604420 |
Business Phone Number: | 2187312320 |
Business Fax Number: | 2188673712 |
Mailing Address: | 1132 28th Ave S, Suite 102 MOORHEAD |
State: | MN |
Postal Code: | 565604420 |
Phone Number: | 2187312320 |
Fax Number: | 2188673712 |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 08/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | LP4052 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |