Provider Demographics
NPI:1902012644
Name:GRAUMANN, CARMEN SUE (LMFT)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:SUE
Last Name:GRAUMANN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 N CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-1546
Mailing Address - Country:US
Mailing Address - Phone:218-739-2391
Mailing Address - Fax:
Practice Address - Street 1:1231 N CONCORD ST
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1546
Practice Address - Country:US
Practice Address - Phone:218-739-2391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1312106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist