| Laurel Psychological Services, Pa | |
|
1108 Grand Ave Saint Paul MN 55105-2618 | |
| (651) 228-0218 | |
| Not Available |
| Full Name | Laurel Psychological Services, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 1108 Grand Ave, Saint Paul, Minnesota |
| Authorized Official Name and Position | John P Ellis (PRESIDENT) |
| Authorized Official Contact | 6512280218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurel Psychological Services, Pa 1108 Grand Ave Saint Paul MN 55105-2618 Ph: (651) 228-0218 | Laurel Psychological Services, Pa 1108 Grand Ave Saint Paul MN 55105-2618 Ph: (651) 228-0218 |
| NPI Number | 1154641132 |
|---|---|
| Provider Enumeration Date | 06/01/2010 |
| Last Update Date | 06/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154641132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP1642 (Minnesota) | Primary |
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