| Collaboration For Psychological Wellness, Llc | |
|
12000 Portland Ave Ste 120 Burnsville MN 55337-4469 | |
| (612) 276-2462 | |
| (612) 246-3682 |
| Full Name | Collaboration For Psychological Wellness, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 12000 Portland Ave Ste 120, Burnsville, Minnesota |
| Authorized Official Name and Position | Tina Dinesh Shah (OWNER/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6122762462 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Collaboration For Psychological Wellness, Llc 12000 Portland Ave Ste 120 Burnsville MN 55337-4469 Ph: (612) 276-2462 | Collaboration For Psychological Wellness, Llc 12000 Portland Ave Ste 120 Burnsville MN 55337-4469 Ph: (612) 276-2462 |
| NPI Number | 1831722594 |
|---|---|
| Provider Enumeration Date | 02/20/2020 |
| Last Update Date | 02/20/2020 |
| Certification Date | 02/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831722594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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