Organization
TWIN CITIES PSYCHOLOGICAL SERVICES, LTD.
Active
Organization
TWIN CITIES PSYCHOLOGICAL SERVICES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE KIM PH.D. (VICE PRESIDENT/PSYCHOLOGIST)
(612) 345-5194
Entity
Organization
Contact information
Practice address
825 NICOLLET MALL, SUITE 1455, MINNEAPOLIS, MN 55402-2606
(612) 345-5194
Mailing address
825 NICOLLET MALL STE 1455, MINNEAPOLIS, MN 55402-2703
(612) 345-5194
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
LP5724
MN
251S00000X
Community/Behavioral Health Agency
LP5726
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407185564
NPI
VA
01
—
179-0012-318
NPI
VA
Enumeration date
05/09/2014
Last updated
02/23/2021
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