Spirited Psychological Services LLC
NPI #1780234955 in Grantsburg, Wisconsin
Provider Information
- NPI Number
- 1780234955
- Entity Type
- Organization
- Organization Name
- Spirited Psychological Services LLC
- Primary Specialty
- Clinic/Center - Mental Health (Including Community Mental Health Center)
- Enumeration Date
- Sep 18, 2019
- Last Updated
- Sep 18, 2019
Practice Location
- Address
- 376 VIOLET CIR
- City
- Grantsburg
- State
- Wisconsin
- ZIP Code
- 54840-8564
- Phone
- (612) 600-8431
Authorized Official
- Name
- DR. CLARENCE LEONARD BONANDER JR., LP
- Title
- OWNER
- Phone
- (612) 600-8431
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
| Point of Service |
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
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