Organization
MICHAEL V. DESANCTIS, PHD, ABPP, LICENSED PSYCHOLOGIST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL VITO DESANCTIS PHD (LICENSED PSYCHOLOGIST)
(651) 225-9222
Entity
Organization
Contact information
Practice address
413 WACOUTA ST STE 550, SAINT PAUL, MN 55101-1645
(651) 225-9222
(651) 225-9224
Mailing address
413 WACOUTA ST STE 550, SAINT PAUL, MN 55101-1645
(651) 225-9222
(651) 225-9224
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1395
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261348400
MINNESOTA HEALTH CARE
MN
Enumeration date
09/16/2010
Last updated
09/28/2010
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