| Ellen S. Teigland, L.p.,p.a. | |
|
520 Nw 1st Ave Grand Rapids MN 55744-2619 | |
| (218) 326-7089 | |
| (218) 326-4714 |
| Full Name | Ellen S. Teigland, L.p.,p.a. |
|---|---|
| Speciality | Psychologist |
| Location | 520 Nw 1st Ave, Grand Rapids, Minnesota |
| Authorized Official Name and Position | Ellen S Teigland (OWNER) |
| Authorized Official Contact | 2183267089 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen S. Teigland, L.p.,p.a. Po Box 794 Grand Rapids MN 55744-0794 Ph: (218) 326-7089 | Ellen S. Teigland, L.p.,p.a. 520 Nw 1st Ave Grand Rapids MN 55744-2619 Ph: (218) 326-7089 |
| NPI Number | 1427243005 |
|---|---|
| Provider Enumeration Date | 09/07/2007 |
| Last Update Date | 09/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427243005 | NPI | - | NPPES |
| 69711TE | Other | MN | BLUE CROSS OF MINNESOTA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP2283 (Minnesota) | Primary |
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