Organization
PSYCHOLOGICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHAN PODRYGULA PH.D. (PRESIDENT)
(701) 852-9113
Entity
Organization
Contact information
Practice address
600 22ND AVE NW, NORTHLAND PROFESSIONAL BUILDING, MINOT, ND 58703-0986
(701) 852-9113
(701) 838-0779
Mailing address
600 22ND AVE NW, NORTHLAND PROFESSIONAL BUILDING, MINOT, ND 58703-0986
(701) 852-9113
(701) 838-0779
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16946
—
ND
01
—
5241
BCBS OF ND
ND
Enumeration date
05/31/2007
Last updated
02/27/2009
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