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General NPI Number Information
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NPI Number | 1134004377
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Entity Type | Organization
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Legal Business Name | SNEHA M RAJ VIKAS PSYCHOLOGY
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 11670 FOUNTAINS DR STE 200
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City | MAPLE GROVE
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State | MN
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Zip | 55369-7195
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Country | US
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Telephone | 612-314-5602
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Fax |
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Provider Business Mailing Address
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Address Line | 11670 FOUNTAINS DR STE 200
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City | MAPLE GROVE
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State | MN
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Zip | 55369-7195
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Country | US
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Telephone | 612-314-5602
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICING CLINICAL PSYCHO
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Name | DR. SNEHA RAJ
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Credential | PSY.D., LP
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Telephone | 612-314-5602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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