Watershed Psychological Services

NPI #1952763351 in Blaine, Minnesota

Provider Information

NPI Number: 1952763351
Entity Type: Organization
Organization Name: Watershed Psychological Services
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Mar 24, 2016
Last Updated: Aug 8, 2016

Practice Location

Address: 4255 PHEASANT RIDGE DRIVE
Address 2: SUITE 412
City: Blaine
State: Minnesota
ZIP Code: 55391
Phone: (763) 317-6222

Authorized Official

Name: MEGAN JEAN BOOM SHEDLOCK, LMFT
Title: CO-OWNER
Phone: (320) 266-4535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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