Provider Demographics
NPI:1235711896
Name:PALMQUIST, MAJA
Entity Type:Individual
Prefix:
First Name:MAJA
Middle Name:
Last Name:PALMQUIST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 SMITH AVE N STE 301
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3355
Mailing Address - Country:US
Mailing Address - Phone:651-220-6142
Mailing Address - Fax:651-220-6707
Practice Address - Street 1:347 SMITH AVE N STE 301
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3355
Practice Address - Country:US
Practice Address - Phone:651-220-6142
Practice Address - Fax:651-220-6707
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program