Provider Demographics
NPI:1114360674
Name:CHRISTENSEN-COWAN, DANIEL GRANT (MSW, LGSW)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:GRANT
Last Name:CHRISTENSEN-COWAN
Suffix:
Gender:M
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 CHEYENNE LN
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1687
Mailing Address - Country:US
Mailing Address - Phone:651-216-1202
Mailing Address - Fax:
Practice Address - Street 1:675 CHEYENNE LN
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1687
Practice Address - Country:US
Practice Address - Phone:651-216-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-14
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN210191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical