| Doctor Name: | DR. HEIDI JO MADSEN |
| NPI Number: | 1144505231 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 448 |
| Business Practice Address: | 701 W 6th St Grafton, ND - 582371379 |
| Business Phone Number: | 7013524335 |
| Business Fax Number: | |
| Mailing Address: | 52 Willow Ct, GRAFTON |
| State: | ND |
| Postal Code: | 582372041 |
| Phone Number: | 6513035944 |
| Fax Number: | |
| NPI Enumeration Date: | 10/20/2011 |
| NPI Last Update Date: | 10/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 448 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |