| Minneapolis Southwest Mental Health Clinic, Limited | |
|
4010 W 65th St Ste 101 Edina MN 55435-1724 | |
| (952) 831-4499 | |
| Not Available |
| Full Name | Minneapolis Southwest Mental Health Clinic, Limited |
|---|---|
| Speciality | Psychologist |
| Location | 4010 W 65th St Ste 101, Edina, Minnesota |
| Authorized Official Name and Position | Dale Bremner Peterson (PRESIDENT) |
| Authorized Official Contact | 9528314499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Minneapolis Southwest Mental Health Clinic, Limited 4010 W 65th St Ste 101 Edina MN 55435-1724 Ph: (952) 831-4499 | Minneapolis Southwest Mental Health Clinic, Limited 4010 W 65th St Ste 101 Edina MN 55435-1724 Ph: (952) 831-4499 |
| NPI Number | 1649485111 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649485111 | NPI | - | NPPES |
| 11702MI | Other | MN | BLUECROSSBLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP2893 (Minnesota) | Primary |
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