Organization
LISA S. SQUIRE, PHD, LP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA SHARON SQUIRE PHD PSYCHOLOGY (OWNER)
(952) 854-2440
Entity
Organization
Contact information
Practice address
7800 METRO PKWY, SUITE 300, BLOOMINGTON, MN 55425-1514
(952) 854-2440
(952) 854-2465
Mailing address
7800 METRO PKWY, SUITE 300, BLOOMINGTON, MN 55425-1514
(952) 854-2440
(952) 854-2465
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MNLP0204
MN
Other
Enumeration date
12/18/2009
Last updated
12/18/2009
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