| Merriam Park Psychological Services, Pa | |
|
1678 Selby Avenue St. Paul MN 55104 | |
| (651) 647-5722 | |
| (651) 647-5723 |
| Full Name | Merriam Park Psychological Services, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 1678 Selby Avenue, St. Paul, Minnesota |
| Authorized Official Name and Position | Alison C Maule-kronmiller (PSYCHOLOGIST) |
| Authorized Official Contact | 6516475722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Merriam Park Psychological Services, Pa 1678 Selby Avenue St. Paul MN 55104 Ph: (651) 647-5722 | Merriam Park Psychological Services, Pa 1678 Selby Avenue St. Paul MN 55104 Ph: (651) 647-5722 |
| NPI Number | 1194937623 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 05/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194937623 | NPI | - | NPPES |
| 826823100 | Other | MN | MEDICAL ASSISTANCE |
| 01H82MA | Other | MN | BCBS GROUP PROVIDER # |
| 01H83MA | Other | MN | BCBS IND. PROVIDER # |
| 107019 | Other | MN | UCARE |
| 6126079 | Other | MN | UBH |
| 1016735 | Other | MN | PREFERRED ONE |
| 6126079 | Other | MN | MEDICA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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