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Organization

MAPLE GROVE COUNSELING CENTER PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ARDITH ANN MESSICCI MA LP (LICENSED PSYCHOLOGIST OWNER)
(763) 494-8699
Entity
Organization

Contact information

Practice address
13700 83RD WAY, STE 205, MAPLE GROVE, MN 55369-7015
(763) 494-8699
(763) 494-8797
Mailing address
13700 83RD WAY, STE 205, MAPLE GROVE, MN 55369-7015
(763) 494-8699
(763) 494-8797

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0951
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3H755ME
BCBS
MN
01
88297
ARAZ
MN
Enumeration date
02/15/2006
Last updated
08/22/2020
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