Individual
DR. STEVEN MARK GIRARDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D., LP
Contact information
Practice address
3005 JAMES AVE S STE 101, MINNEAPOLIS, MN 55408-2533
(612) 227-0244
(612) 377-7501
Mailing address
3005 JAMES AVE S STE 101, MINNEAPOLIS, MN 55408-2533
(612) 227-0244
(612) 377-7501
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 3715
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203229853 55408A0001
TRICARE PROVIDER NUMBER
MN
01
—
370 G9GI
BLUE CROSS BLUE SHIELD MN
MN
01
—
62-46819
UBH PROVIDER ID
MN
Enumeration date
01/12/2007
Last updated
07/08/2007
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