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12940 Harriet Ave S Suite 250 Burnsville MN 55337-2680 | |
(952) 435-4074 | |
(952) 435-6074 |
Full Name | |
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Speciality | Psychologist |
Location | 12940 Harriet Ave S, Burnsville, Minnesota |
Authorized Official Name and Position | Joy Piccolino (CEO) |
Authorized Official Contact | 9524354074 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12940 Harriet Ave S Suite 250 Burnsville MN 55337-2680 Ph: (952) 435-4074 | 12940 Harriet Ave S Suite 250 Burnsville MN 55337-2680 Ph: (952) 435-4074 |
NPI Number | 1316084270 |
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Provider Enumeration Date | 01/31/2007 |
Last Update Date | 04/10/2014 |
Identifier | Type | State | Issuer |
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1316084270 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | LP4179 (Minnesota) | Primary |
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