Doctor Name: | WAYNE ANTHONY ARNZEN |
NPI Number: | 1780738385 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.P |
License Number: | LP 1185 |
Business Practice Address: | 342 Pike Lake Rd Grand Marais, MN - 556042230 |
Business Phone Number: | 2183871098 |
Business Fax Number: | 2183871098 |
Mailing Address: | 342 Pike Lake Rd, GRAND MARAIS |
State: | MN |
Postal Code: | 556042230 |
Phone Number: | 2183871098 |
Fax Number: | 2183871098 |
NPI Enumeration Date: | 01/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | LP 1185 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |