Laurel Psychological Services, PA

NPI #1154641132 in Saint Paul, Minnesota

Provider Information

NPI Number: 1154641132
Entity Type: Organization
Organization Name: Laurel Psychological Services, PA
Primary Specialty: Psychologist
Enumeration Date: Jun 1, 2010
Last Updated: Jun 1, 2010

Practice Location

Address: 1108 GRAND AVE
City: Saint Paul
State: Minnesota
ZIP Code: 55105-2618
Phone: (651) 228-0218

Authorized Official

Name: DR. JOHN P ELLIS, PHD
Title: PRESIDENT
Phone: (651) 228-0218

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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