Organization
KSA PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA SCOTT LP (CO-OWNER/MANAGER)
(612) 298-9587
Entity
Organization
Contact information
Practice address
5603 CHICAGO AVE., MINNEAPOLIS, MN 55417
(612) 298-9587
Mailing address
1034 BROMPTON PLACE, MENDOTA HEIGHTS, MN 55118
(612) 998-9587
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP4436
MN
103TC0700X
Clinical Psychologist
LP4679
MN
103TC0700X
Clinical Psychologist
Primary
LP4687
MN
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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