Individual
DR. ILYSSA SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3506 AQUILA AVE N, NEW HOPE, MN 55427-1845
(763) 746-6144
Mailing address
3506 AQUILA AVE N, NEW HOPE, MN 55427-1845
(763) 746-6144
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP6139
MN
Other
Enumeration date
11/18/2010
Last updated
05/17/2024
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