| Lakes Consultation Group | |
|
1155 Ford Road Unit B St Louis Park MN 55426 | |
| (952) 378-1800 | |
| (952) 378-1714 |
| Full Name | Lakes Consultation Group |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1155 Ford Road, St Louis Park, Minnesota |
| Authorized Official Name and Position | Ani C Ram (OFFICE MANAGER) |
| Authorized Official Contact | 9523781800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakes Consultation Group 1155 Ford Road Unit B St Louis Park MN 55426 Ph: (952) 378-1800 | Lakes Consultation Group 1155 Ford Road Unit B St Louis Park MN 55426 Ph: (952) 378-1800 |
| NPI Number | 1881753564 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 01/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881753564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 103TC0700X (Minnesota) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2084P0800X (* (Not Available)) | Primary |
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