Organization
PEDIATRIC CONSULTATION SPECIALISTS, PLLC
Active
Other names
Psychology Consultation Specialists, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA KUPERMAN SONDELL PHD (LICENSED PSYCHOLOGIST/OWNER)
(763) 746-2707
Entity
Organization
Contact information
Practice address
3300 FERNBROOK LANE N, #120, PLYMOUTH, MN 55447
(763) 559-7050
(763) 559-7060
Mailing address
3300 FERNBROOK LANE N, #120, PLYMOUTH, MN 55447
(763) 559-7050
(763) 559-7060
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP4585
MN
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
05/28/2008
Last updated
06/04/2019
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