Organization
SHORES THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL SHORES PSYD, LP (PSYCHOLOGIST)
(651) 900-4808
Entity
Organization
Contact information
Practice address
557 7TH ST W, SAINT PAUL, MN 55102-3065
(651) 900-4808
Mailing address
674 OTTAWA AVE, SAINT PAUL, MN 55107-2555
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP5721
MN
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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