Individual
MR. CRAIG POLSFUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LP, MSW
Contact information
Practice address
15552 DYNASTY WAY, APPLE VALLEY, MN 55124-7836
(612) 730-4843
(651) 344-8298
Mailing address
15552 DYNASTY WAY, APPLE VALLEY, MN 55124
(612) 730-4843
(651) 344-8298
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0620
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013848700
—
MN
Enumeration date
06/27/2005
Last updated
07/21/2022
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