Organization
SOUTH SUBURBAN PSYCHOLOGICAL & COUNSELING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES FERRARESE PH.D., L.P. (PSYCHOLOGIST/OWNER)
(952) 431-6862
Entity
Organization
Contact information
Practice address
4635 NICOLS RD, SUITE 200, EAGAN, MN 55122-3337
(952) 431-6862
Mailing address
4635 NICOLS RD, SUITE 200, EAGAN, MN 55122-3337
(952) 431-6862
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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