Organization
LAUREL PSYCHOLOGICAL SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN P ELLIS PHD (PRESIDENT)
(651) 228-0218
Entity
Organization
Contact information
Practice address
1108 GRAND AVE, SAINT PAUL, MN 55105-2618
(651) 228-0218
Mailing address
1108 GRAND AVE, SAINT PAUL, MN 55105-2618
(651) 228-0218
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1642
MN
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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