Organization
MINNESOTA FAMILY PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCIA ROGERS PSY.D. (OWNER)
(763) 424-3704
Entity
Organization
Contact information
Practice address
7382 KIRKWOOD CT, MAPLE GROVE, MN 55369-5270
(763) 424-3704
(763) 424-8315
Mailing address
7382 KIRKWOOD CT, MAPLE GROVE, MN 55369-5270
(763) 424-3704
(763) 424-8315
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3691
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
359G0RO
BLUE CROSS
MN
Enumeration date
05/26/2007
Last updated
08/22/2020
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