Organization
NORTHSTAR PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD M. WAHL (PSYCHOLOGIST)
(701) 415-8271
Entity
Organization
Contact information
Practice address
900 LONG LAKE RD STE 320, NEW BRIGHTON, MN 55112-6439
(651) 482-9361
Mailing address
2055 XAVIER ST APT 217, BISMARCK, ND 58501-1413
(701) 415-8271
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
07/13/2017
Last updated
07/21/2022
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