South Suburban Psychological & Counseling Services, Pllc

NPI #1477859437 in Eagan, Minnesota

Provider Information

NPI Number
1477859437
Entity Type
Organization
Organization Name
South Suburban Psychological & Counseling Services, Pllc
Primary Specialty
Psychologist - Clinical
Enumeration Date
Feb 8, 2011
Last Updated
Feb 8, 2011

Practice Location

Address
4635 NICOLS RD
Address 2
SUITE 200
City
Eagan
ZIP Code
55122-3337
Phone
(952) 431-6862

Authorized Official

Name
MICHAEL JAMES FERRARESE, PH.D., L.P.
Title
PSYCHOLOGIST/OWNER
Phone
(952) 431-6862

Specialties & Taxonomy Codes

Specialty
Psychologist - ClinicalClinical

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