Provider Demographics
NPI:1659622561
Name:NIEUWENHUIS, SYNNOVE (LMFT, RPT)
Entity Type:Individual
Prefix:MRS
First Name:SYNNOVE
Middle Name:
Last Name:NIEUWENHUIS
Suffix:
Gender:F
Credentials:LMFT, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 12TH ST E
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:MN
Mailing Address - Zip Code:55336-2336
Mailing Address - Country:US
Mailing Address - Phone:320-864-6139
Mailing Address - Fax:
Practice Address - Street 1:925 12TH ST E
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:MN
Practice Address - Zip Code:55336-2336
Practice Address - Country:US
Practice Address - Phone:320-864-6139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist