PENTICOFF COMMUNITY COUNSELING, INC.
Organization (NPI-2)
Active
Psychologist, Clinical
Provider Information
- NPI Number
1588896310- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 1818 WOODDALE DR STE 204, WOODBURY, MN, 551252983
- Phone
- (651) 255-6678
- Fax
- (651) 501-6091
Specialties & Taxonomies
Psychologist, Clinical
Primary License: MN #LP-4060