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1245975010
PORTAGE PSYCHOLOGY PA
EDEN PRAIRIE, MN
NPI
1245975010
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Entity Type
Organization
Authorized Contact
ANNA KRULL
Vice President
612-986-3333
Organization Subpart ?
No
Primary Taxonomy
103T00000X Psychologist
Enumeration Date
2022-05-04
Last Update Date
2022-05-04
Business Address
PORTAGE PSYCHOLOGY PA
10125 CROSSTOWN CIR STE 110
EDEN PRAIRIE, MN 55344-3316
Phone number: 612-688-5933
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Mailing Address
PORTAGE PSYCHOLOGY PA
10125 CROSSTOWN CIR STE 110
EDEN PRAIRIE, MN 55344-3316
Phone number: 612-688-5933
Copy
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