| Prairie Psychological Services Pa | |
|
205 W Fletcher St Crookston MN 56716-1945 | |
| (281) 281-2117 | |
| Not Available |
| Full Name | Prairie Psychological Services Pa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 205 W Fletcher St, Crookston, Minnesota |
| Authorized Official Name and Position | David G Jansen (OWNER AND DIRECTOR) |
| Authorized Official Contact | 2182812117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Psychological Services Pa 205 W Fletcher St Crookston MN 56716-1945 Ph: (281) 281-2117 | Prairie Psychological Services Pa 205 W Fletcher St Crookston MN 56716-1945 Ph: (281) 281-2117 |
| NPI Number | 1740506393 |
|---|---|
| Provider Enumeration Date | 04/07/2010 |
| Last Update Date | 07/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740506393 | NPI | - | NPPES |
| 330748400 | Medicaid | MN | |
| 6192932 | Other | MN | MEDICA |
| 63658PR | Other | MN | BCBS OF MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Minnesota) | Primary |
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