Provider Demographics
NPI:1902181514
Name:SEMRUD-CLIKEMAN, MARGARET ELAINE (PHD LP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELAINE
Last Name:SEMRUD-CLIKEMAN
Suffix:
Gender:F
Credentials:PHD LP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:ELAINE
Other - Last Name:SEMRUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 486
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-625-6964
Mailing Address - Fax:612-624-1446
Practice Address - Street 1:516 DELAWARE ST SE
Practice Address - Street 2:4-100 PWB, CLINIC 4A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0356
Practice Address - Country:US
Practice Address - Phone:612-625-6964
Practice Address - Fax:612-624-1446
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist