| Bourdeaux Psychological Services | |
|
4425 311th St Stacy MN 55079-9299 | |
| (612) 326-0775 | |
| (161) 243-5411 |
| Full Name | Bourdeaux Psychological Services |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4425 311th St, Stacy, Minnesota |
| Authorized Official Name and Position | Monique Marie Bourdeaux-colburn (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6123260775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bourdeaux Psychological Services 4425 311th St Stacy MN 55079-9299 Ph: (612) 326-0775 | Bourdeaux Psychological Services 4425 311th St Stacy MN 55079-9299 Ph: (612) 326-0775 |
| NPI Number | 1689034910 |
|---|---|
| Provider Enumeration Date | 02/29/2016 |
| Last Update Date | 02/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689034910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP5690 (Minnesota) | Primary |
Sumus Health, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6020 302nd St, Stacy, MN 55079 Phone: 612-418-9391 |