Provider Demographics
NPI:1396025532
Name:NORDSTROM-LOEB, BARBARA ELLEN (LMFT, BC-DMT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ELLEN
Last Name:NORDSTROM-LOEB
Suffix:
Gender:F
Credentials:LMFT, BC-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4632 YORK AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1866
Mailing Address - Country:US
Mailing Address - Phone:612-925-5277
Mailing Address - Fax:
Practice Address - Street 1:4632 YORK AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1866
Practice Address - Country:US
Practice Address - Phone:612-925-5277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1976106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist