| Psychological Resources Group | |
|
8490 Woodbury Xing Ste 107 Woodbury MN 55125-9433 | |
| (612) 481-1600 | |
| (651) 731-6345 |
| Full Name | Psychological Resources Group |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 8490 Woodbury Xing, Woodbury, Minnesota |
| Authorized Official Name and Position | James Thomas Richardson (OWNER) |
| Authorized Official Contact | 6124811600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Resources Group 8490 Woodbury Xing Ste 107 Woodbury MN 55125-9433 Ph: (612) 481-1600 | Psychological Resources Group 8490 Woodbury Xing Ste 107 Woodbury MN 55125-9433 Ph: (612) 481-1600 |
| NPI Number | 1639232556 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 07/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639232556 | NPI | - | NPPES |
| 242227100 | Medicaid | MN | |
| 62-36220 | Other | MN | UBH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | LP2150 (Minnesota) | Primary |
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