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DR. DUANE HENRY ERSTAD PH.D.

>> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1417175571

Individual Registrant:
DR. DUANE HENRY ERSTAD PH.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
CARRERA 13, NO. 85-39 SUITE 608 BOGOTA, DC 00000 CO
Tel: 414-550-4515  Fax: --

Contact information for business:
1233 19TH AVE NE  ROCHESTER, MN 55906-4317 US
Tel: 414-550-4515  Fax: --

Registration Information:
NPI: 1417175571
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
Psychologist
WI2094

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
42149800WI05




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