| Doctor Name: | EDMUND EDWARD NADOLNY |
| NPI Number: | 1043481658 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | LP0891 |
| Business Practice Address: | 1000 Willmar Ave Sw Behavioral Forensic Services Willmar, MN - 562013067 |
| Business Phone Number: | 3202353004 |
| Business Fax Number: | 3202353008 |
| Mailing Address: | Po Box 495, WILLMAR |
| State: | MN |
| Postal Code: | 562010495 |
| Phone Number: | 3202353004 |
| Fax Number: | 3202353008 |
| NPI Enumeration Date: | 03/23/2008 |
| NPI Last Update Date: | 03/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0200X |
| License Number: | LP0891 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Forensic |
| Taxonomy Definition: | |