| South Metro Therapy Llc | |
|
9202 202nd St W Ste 201 Lakeville MN 55044-7917 | |
| (952) 567-3399 | |
| Not Available |
| Full Name | South Metro Therapy Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 9202 202nd St W Ste 201, Lakeville, Minnesota |
| Authorized Official Name and Position | Nergis Petersen (THERAPIST) |
| Authorized Official Contact | 9525673399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Metro Therapy Llc 17898 179th Trl W Lakeville MN 55044-7248 Ph: (952) 250-4072 | South Metro Therapy Llc 9202 202nd St W Ste 201 Lakeville MN 55044-7917 Ph: (952) 567-3399 |
| NPI Number | 1144691411 |
|---|---|
| Provider Enumeration Date | 10/13/2015 |
| Last Update Date | 10/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144691411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | CC00807 (Minnesota) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | CC00807 (Minnesota) | Primary |
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