| Ppsm | |
|
1061 Grand Ave Saint Paul MN 55105-3002 | |
| (651) 212-4920 | |
| Not Available |
| Full Name | Ppsm |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1061 Grand Ave, Saint Paul, Minnesota |
| Authorized Official Name and Position | Nicole Uzendoski (LICSW) |
| Authorized Official Contact | 6126440415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppsm 1061 Grand Ave Saint Paul MN 55105-3002 Ph: (651) 212-4920 | Ppsm 1061 Grand Ave Saint Paul MN 55105-3002 Ph: (651) 212-4920 |
| NPI Number | 1467829168 |
|---|---|
| Provider Enumeration Date | 08/28/2015 |
| Last Update Date | 08/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467829168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 17773 (Minnesota) | Primary |
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