| Sally R Brinza Phd Lp Llc | |
|
7225 Forestview Ln N Maple Grove MN 55369-5501 | |
| (612) 978-5058 | |
| Not Available |
| Full Name | Sally R Brinza Phd Lp Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7225 Forestview Ln N, Maple Grove, Minnesota |
| Authorized Official Name and Position | Sally Rose Brinza (PSYCHOLOGIST) |
| Authorized Official Contact | 6129785058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally R Brinza Phd Lp Llc 7225 Forestview Ln N Maple Grove MN 55369-5501 Ph: (612) 978-5058 | Sally R Brinza Phd Lp Llc 7225 Forestview Ln N Maple Grove MN 55369-5501 Ph: (612) 978-5058 |
| NPI Number | 1972802361 |
|---|---|
| Provider Enumeration Date | 03/24/2011 |
| Last Update Date | 03/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972802361 | NPI | - | NPPES |
| 7140533-00 | Other | MN | MINNESOTA HEALTH CARE PROGRAM MA |
| 6420206 | Other | MN | MINNESOTA CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP2586 (Minnesota) | Primary |
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