Portage Psychology PA
NPI #1245975010 in Eden Prairie, Minnesota
Provider Information
- NPI Number
- 1245975010
- Entity Type
- Organization
- Organization Name
- Portage Psychology PA
- Primary Specialty
- Psychologist
- Enumeration Date
- May 4, 2022
- Last Updated
- May 4, 2022
Practice Location
- Address
- 10125 CROSSTOWN CIR STE 110
- City
- Eden Prairie
- State
- Minnesota
- ZIP Code
- 55344-3316
- Phone
- (612) 688-5933
Authorized Official
- Name
- DR. ANNA KRULL, PSYD, LP
- Title
- VICE-PRESIDENT
- Phone
- (612) 986-3333
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist |
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