Provider Demographics
NPI:1356844203
Name:CHRISTENSON, EMILY JEAN
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
Last Name:CHRISTENSON
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 1:530 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LE SUEUR
Mailing Address - State:MN
Mailing Address - Zip Code:56058-1535
Mailing Address - Country:US
Mailing Address - Phone:952-737-8234
Mailing Address - Fax:
Practice Address - Street 1:522 MAIN ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:MN
Practice Address - Zip Code:56044-7709
Practice Address - Country:US
Practice Address - Phone:507-858-3019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3595106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist