Provider Demographics
NPI:1013765965
Name:WINTER, RAIJA S
Entity Type:Individual
Prefix:
First Name:RAIJA
Middle Name:S
Last Name:WINTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 92ND AVE W
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55808-1534
Mailing Address - Country:US
Mailing Address - Phone:218-591-3707
Mailing Address - Fax:
Practice Address - Street 1:600 E SUPERIOR ST STE 502
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2200
Practice Address - Country:US
Practice Address - Phone:218-327-2001
Practice Address - Fax:218-327-0456
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health