Organization
BOURDEAUX PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONIQUE MARIE BOURDEAUX-COLBURN PSY.D, LP (LICENSED PSYCHOLOGIST)
(612) 326-0775
Entity
Organization
Contact information
Practice address
4425 311TH ST, STACY, MN 55079-9299
(612) 326-0775
(161) 243-5411
Mailing address
4425 311TH ST, STACY, MN 55079-9299
(612) 326-0775
(161) 243-5411
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP5690
MN
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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