Provider Demographics
NPI:1922375757
Name:CARLSON, HARMONY ANN (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:HARMONY
Middle Name:ANN
Last Name:CARLSON
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 AMUNDSON CIR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4132
Mailing Address - Country:US
Mailing Address - Phone:651-300-8135
Mailing Address - Fax:
Practice Address - Street 1:333 MAIN ST N STE 110
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5054
Practice Address - Country:US
Practice Address - Phone:651-425-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 5418103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical