| Psychological Consultants Of So Mn Pa | |
|
4663 White Bear Pkwy White Bear Lake MN 55110-3300 | |
| (612) 508-9309 | |
| Not Available |
| Full Name | Psychological Consultants Of So Mn Pa |
|---|---|
| Speciality | Psychologist |
| Location | 4663 White Bear Pkwy, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Paul Reitman (OWNER) |
| Authorized Official Contact | 6125089309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Consultants Of So Mn Pa 3230 Orchard Ct White Bear Lake MN 55110-5385 Ph: (612) 508-9309 | Psychological Consultants Of So Mn Pa 4663 White Bear Pkwy White Bear Lake MN 55110-3300 Ph: (612) 508-9309 |
| NPI Number | 1841316015 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 04/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841316015 | NPI | - | NPPES |
| 452444600 | Medicaid | MN | |
| 41511PS | Other | MN | BLUE CROSS MINNESOTA |
| 1007131 | Other | MN | PREFERRED ONE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (Minnesota) | Primary |
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