Organization
MCGOVERN PSYCHOTHERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA RACHEL MCGOVERN PH.D. (OWNER)
(551) 486-5221
Entity
Organization
Contact information
Practice address
3340 REPUBLIC AVE STE 120, ST LOUIS PARK, MN 55426-4189
(612) 564-8897
Mailing address
3340 REPUBLIC AVE STE 120, ST LOUIS PARK, MN 55426-4189
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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