Individual
EWA X PECZALSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LP
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
(651) 351-0827
Mailing address
927 CHURCHILL ST W, MEDICAL STAFF SERVICES, STILLWATER, MN 55082-6605
(651) 430-8537
(651) 430-4646
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1995
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43728300
—
WI
Enumeration date
02/02/2006
Last updated
12/13/2007
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