Organization
SABA GHAZIMOGHADAM, PH.D., LP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SABA GHAZIMOGHADAM PH.D. (PSYCHOLOGIST/OWNER)
(612) 308-3623
Entity
Organization
Contact information
Practice address
6582 WILLOW CT, MINNETRISTA, MN 55364-8630
(612) 308-3623
Mailing address
6582 WILLOW CT, MINNETRISTA, MN 55364-8630
(612) 308-3623
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
LP5561
MN
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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