| Mary R. Boehlke Psy.d. P.c. | |
|
1660 Highway 100 S Ste. 568 St Louis Park MN 55416-1529 | |
| (952) 545-6800 | |
| Not Available |
| Full Name | Mary R. Boehlke Psy.d. P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 1660 Highway 100 S, St Louis Park, Minnesota |
| Authorized Official Name and Position | Mary Boehlke (PRESIDENT) |
| Authorized Official Contact | 9525456800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary R. Boehlke Psy.d. P.c. 17935 2nd Ave N Plymouth MN 55447-3486 Ph: (763) 476-4924 | Mary R. Boehlke Psy.d. P.c. 1660 Highway 100 S Ste. 568 St Louis Park MN 55416-1529 Ph: (952) 545-6800 |
| NPI Number | 1801094982 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801094982 | NPI | - | NPPES |
| 1G182BO | Other | MN | BLUE CROSS OF MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | MN LP0708 (Minnesota) | Primary |
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