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WOLFRAM ASSOCIATES, LTD.

Clinical Neuropsychologist

Saint Cloud, Minnesota

Provider NPI: 1679664254

Organization Information:
Organization Name:  WOLFRAM ASSOCIATES, LTD.
Organization is not Subpart
Authorized Official:  TIMOTHY J. WOLFRAM  PRESIDENT  320-4201146

Practice Location:
2700 1ST ST N SUITE 209 SAINT CLOUD, MN 56303 US
Tel: 320-420-1146  Fax: 320-258-4380

Business Mailing Address:
5709 MEADOWLARK CT  SAINT CLOUD, MN 56303 US
Tel: 320-420-1146  Fax: 320-258-4380

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MNLP3758
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
MNLP3758

Other Provider Identifiers:

IssuerNumberStateType
BLUECROSS BLUESHIELD71Q68WO01
HEALTH PARTNERS10121901
BLUECROSS BLUESHIELD71Q69WO01
PREFERREDONE101497301
174708800MN05
UNITED BEHAVIORAL HEALTH610210401
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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