Healthcare Provider Details

I. General information

NPI: 1659762169
Provider Name (Legal Business Name): TORBORG & KOBIENIA PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W SAINT GERMAIN ST STE 200
SAINT CLOUD MN
56301-4059
US

IV. Provider business mailing address

1740 W SAINT GERMAIN ST STE 200
SAINT CLOUD MN
56301-4059
US

V. Phone/Fax

Practice location:
  • Phone: 320-249-5207
  • Fax: 320-656-5800
Mailing address:
  • Phone: 320-249-5207
  • Fax: 320-656-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number1193
License Number StateMN

VIII. Authorized Official

Name: MRS. CARRIE L KOBIENIA
Title or Position: MARRIAGE AND FAMILY THERAPSIT
Credential: MS
Phone: 320-249-5207