| Community Psychology Of Minnesota, Llc | |
|
1895 Laurel Ave Saint Paul MN 55104-5938 | |
| (651) 647-4944 | |
| (651) 646-6176 |
| Full Name | Community Psychology Of Minnesota, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1895 Laurel Ave, Saint Paul, Minnesota |
| Authorized Official Name and Position | Bradley Lee Kinder (CEO) |
| Authorized Official Contact | 6516474944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Psychology Of Minnesota, Llc 1895 Laurel Ave Saint Paul MN 55104-5938 Ph: (651) 647-4944 | Community Psychology Of Minnesota, Llc 1895 Laurel Ave Saint Paul MN 55104-5938 Ph: (651) 647-4944 |
| NPI Number | 1326343088 |
|---|---|
| Provider Enumeration Date | 01/11/2011 |
| Last Update Date | 01/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326343088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 4383 (Minnesota) | Primary |
| 106H00000X | Marriage & Family Therapist | 392 (Minnesota) | Secondary |
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