Unknown Individual – Psychologist, NPI 1104824234
Psychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1310 HIGHWAY 96 E
SUITE 104C
WHITE BEAR LAKE, MN 551103624
Phone: (612) 203-8654
Fax: (651) 762-3780
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 55110)
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