Provider Demographics
NPI:1376626119
Name:STROMMEN, DAWN HOFSTAD (MA)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:HOFSTAD
Last Name:STROMMEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 DUNHAM DR
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-1125
Mailing Address - Country:US
Mailing Address - Phone:734-427-1075
Mailing Address - Fax:
Practice Address - Street 1:1485 81ST AVE NE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:55432-2111
Practice Address - Country:US
Practice Address - Phone:763-780-3036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health