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Individual

DR. DOROTHY THERESE SOUKUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD LP

Contact information

Practice address
2385 TROOP DRIVE, SUITE 202, SARTELL, MN 56377
(320) 253-2385
(320) 253-2386
Mailing address
2385 TROOP DRIVE, SUITE 202, SARTELL, MN 56377
(320) 253-2385
(320) 253-2386

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3278
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
991437400
MN
Enumeration date
09/27/2006
Last updated
10/16/2017
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