| Dynamic Path Psychological Services, Llc | |
|
6230 10th St N Ste 210 Oakdale MN 55128-6158 | |
| (651) 317-3656 | |
| Not Available |
| Full Name | Dynamic Path Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6230 10th St N Ste 210, Oakdale, Minnesota |
| Authorized Official Name and Position | Katrina Samlaska (OWNER/OPERATOR) |
| Authorized Official Contact | 6513173656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Path Psychological Services, Llc 6230 10th St N Ste 210 Oakdale MN 55128-6158 Ph: (651) 317-3656 | Dynamic Path Psychological Services, Llc 6230 10th St N Ste 210 Oakdale MN 55128-6158 Ph: (651) 317-3656 |
| NPI Number | 1275819914 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 10/26/2011 |
| Medicare PECOS PAC ID | 0042470924 |
|---|---|
| Medicare Enrollment ID | O20120330000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275819914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5411 (Minnesota) | Primary |
| Provider Name | Katrina N Samlaska |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215211362 PECOS PAC ID: 9335315514 Enrollment ID: I20120110000739 |
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