Provider Demographics
NPI:1316025877
Name:CHRISTIANSON, MONIKA DOROTHEA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:DOROTHEA
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 WOODHILL DR APT 72
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2358
Mailing Address - Country:US
Mailing Address - Phone:651-766-9006
Mailing Address - Fax:
Practice Address - Street 1:311 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2323
Practice Address - Country:US
Practice Address - Phone:651-290-2559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 0985103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01011955OtherPREFERRED ONE
MN02790 CHOtherBCBS