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Organization

MELISSA ANDERSON PSYCHOLOGICAL SERVICES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MELISSA JEAN ANDERSON PSYD (PSYCHOLOGIST/OWNER)
(218) 485-4445
Entity
Organization

Contact information

Practice address
316 ELM AVE, MOOSE LAKE, MN 55767-7706
(218) 485-4445
(218) 485-0477
Mailing address
316 ELM AVE, PO BOX 243, MOOSE LAKE, MN 55767-7706
(218) 485-4445
(218) 485-0477

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5864
MN
106H00000X
Marriage & Family Therapist
1494
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
094906000
MN
Enumeration date
05/11/2015
Last updated
05/11/2015
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