Provider Demographics
NPI:1245754019
Name:RAJ, SNEHA MADHWA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SNEHA
Middle Name:MADHWA
Last Name:RAJ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 SUNWOOD DR NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-5190
Mailing Address - Country:US
Mailing Address - Phone:763-236-0000
Mailing Address - Fax:
Practice Address - Street 1:7231 SUNWOOD DR NW
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-5190
Practice Address - Country:US
Practice Address - Phone:763-236-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6214103T00000X
IN20043025103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical