Maple Grove Counseling Center PA

NPI #1164496071 in Maple Grove, Minnesota

Provider Information

NPI Number: 1164496071
Entity Type: Organization
Organization Name: Maple Grove Counseling Center PA
Primary Specialty: Psychologist
Enumeration Date: Feb 15, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 13700 83RD WAY
Address 2: STE 205
City: Maple Grove
State: Minnesota
ZIP Code: 55369-7015
Phone: (763) 494-8699

Authorized Official

Name: MRS. ARDITH ANN MESSICCI, MA LP
Title: LICENSED PSYCHOLOGIST OWNER
Phone: (763) 494-8699

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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