Provider Demographics
NPI:1780716977
Name:GRAUDS, DEAN S (MA,)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:S
Last Name:GRAUDS
Suffix:
Gender:M
Credentials:MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18020 28TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1627
Mailing Address - Country:US
Mailing Address - Phone:763-383-0247
Mailing Address - Fax:763-577-9924
Practice Address - Street 1:700 TWELVE OAKS CENTER DR
Practice Address - Street 2:#260 UPSTAIRS
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4401
Practice Address - Country:US
Practice Address - Phone:763-383-0247
Practice Address - Fax:763-577-9924
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00104101YM0800X
MN1325106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist