Provider Demographics
NPI:1982701777
Name:ARLANDSON, MARTHA R (EDS, NCSP)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:R
Last Name:ARLANDSON
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 OAKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55110-1824
Mailing Address - Country:US
Mailing Address - Phone:651-407-9458
Mailing Address - Fax:
Practice Address - Street 1:1485 81ST AVE NE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE PARK
Practice Address - State:MN
Practice Address - Zip Code:55432-2111
Practice Address - Country:US
Practice Address - Phone:763-780-3036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN358467103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool