| Gurganus Psychological Services, Llc | |
|
7241 Ohms Lane Suite 145 Edina MN 55439-2136 | |
| (952) 920-0711 | |
| (952) 920-0716 |
| Full Name | Gurganus Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7241 Ohms Lane, Edina, Minnesota |
| Authorized Official Name and Position | Sara Lea Gurganus (OWNER) |
| Authorized Official Contact | 9529200711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gurganus Psychological Services, Llc 7241 Ohms Lane Suite 145 Edina MN 55439-2136 Ph: (952) 920-0711 | Gurganus Psychological Services, Llc 7241 Ohms Lane Suite 145 Edina MN 55439-2136 Ph: (952) 920-0711 |
| NPI Number | 1316910383 |
|---|---|
| Provider Enumeration Date | 02/09/2006 |
| Last Update Date | 07/07/2014 |
| Medicare PECOS PAC ID | 2163449778 |
|---|---|
| Medicare Enrollment ID | O20051101001147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316910383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP4536 (Minnesota) | Primary |
| Provider Name | Sara Lea Gurganus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598953598 PECOS PAC ID: 2163464702 Enrollment ID: I20050524001286 |
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