Individual
NINA JEAN SYVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA., MSE.,LP
Contact information
Practice address
14165 JAMES RD STE 200, ROGERS, MN 55374-9317
(763) 428-6330
(763) 428-6314
Mailing address
1485 81ST AVE NE, SPRING LAKE PARK, MN 55432-2111
(763) 780-3036
(763) 784-0784
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1892
MN
Other
Enumeration date
11/17/2006
Last updated
06/30/2009
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