| Peggy Maki Phd Llc | |
|
10520 Wayzata Blvd #100 Minnetonka MN 55305-1511 | |
| (612) 819-2750 | |
| Not Available |
| Full Name | Peggy Maki Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 10520 Wayzata Blvd, Minnetonka, Minnesota |
| Authorized Official Name and Position | Peggy Susan Maki (OWNER AND PSYCHOLOGIST) |
| Authorized Official Contact | 6128192750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peggy Maki Phd Llc 10520 Wayzata Blvd #100 Minnetonka MN 55305-1511 Ph: (612) 819-2750 | Peggy Maki Phd Llc 10520 Wayzata Blvd #100 Minnetonka MN 55305-1511 Ph: (612) 819-2750 |
| NPI Number | 1518381235 |
|---|---|
| Provider Enumeration Date | 02/17/2014 |
| Last Update Date | 06/26/2014 |
| Medicare PECOS PAC ID | 4981796372 |
|---|---|
| Medicare Enrollment ID | O20140225000623 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518381235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP 5729 (Minnesota) | Primary |
| Provider Name | Peggy Susan Maki |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720171382 PECOS PAC ID: 2769492958 Enrollment ID: I20140225000993 |
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