Provider Demographics
NPI:1144363409
Name:TRULSEN, MARLIN OSCAR (PHD)
Entity type:Individual
Prefix:
First Name:MARLIN
Middle Name:OSCAR
Last Name:TRULSEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 287
Mailing Address - Street 2:521 BROADWAY AVENUE NORTH FIVE COUNTY MENTAL HEALTH CE
Mailing Address - City:BRAHAM
Mailing Address - State:MN
Mailing Address - Zip Code:55006
Mailing Address - Country:US
Mailing Address - Phone:320-396-3333
Mailing Address - Fax:320-396-3363
Practice Address - Street 1:521 BROADWAY AVENUE NORTH
Practice Address - Street 2:FIVE COUNTY MENTAL HEALTH CENTER BRAHAM
Practice Address - City:BRAHAM
Practice Address - State:MN
Practice Address - Zip Code:55006
Practice Address - Country:US
Practice Address - Phone:320-396-3333
Practice Address - Fax:320-396-3363
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP4044103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist