Provider Demographics
NPI:1457652380
Name:CHRISTENSEN-COWAN, KATRIN MARIE
Entity Type:Individual
Prefix:
First Name:KATRIN
Middle Name:MARIE
Last Name:CHRISTENSEN-COWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATRIN
Other - Middle Name:MARIE MILLER
Other - Last Name:COWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LGSW
Mailing Address - Street 1:675 CHEYENNE LN
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1687
Mailing Address - Country:US
Mailing Address - Phone:612-293-0768
Mailing Address - Fax:
Practice Address - Street 1:2637 27TH AVE S STE 201
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3080
Practice Address - Country:US
Practice Address - Phone:612-293-0768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN19945104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker