Individual
PATRICIA J. MACTAGGERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,L.P.
Contact information
Practice address
2301 LOST LAKE CT, MOUND, MN 55364-4512
(612) 803-2533
Mailing address
2301 LOST LAKE CT, MOUND, MN 55364-4512
(612) 803-2533
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2278
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68413ST
BLUECROSSBLUESHIELD PROVI
MN
Enumeration date
03/04/2007
Last updated
08/22/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us