Provider Demographics
NPI:1679189336
Name:ANDRESEN DAMMANN, KATE (MA OF COUNSELING)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:ANDRESEN DAMMANN
Suffix:
Gender:F
Credentials:MA OF COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 PHEASANT RIDGE DR NE STE 412
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-5066
Mailing Address - Country:US
Mailing Address - Phone:651-387-2035
Mailing Address - Fax:
Practice Address - Street 1:4255 PHEASANT RIDGE DR NE STE 412
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5066
Practice Address - Country:US
Practice Address - Phone:651-387-2035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health