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General NPI Number Information
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NPI Number | 1275568271
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Entity Type | Organization
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Legal Business Name | RIVER VALLEY PSYCHOLOGICAL SERVICES INC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 215 N 2ND ST SUITE 101
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City | RIVER FALLS
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State | WI
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Zip | 54022
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Country | US
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Telephone | 715-425-8899
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Fax | 715-425-5590
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Provider Business Mailing Address
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Address Line | 215 N 2ND ST SUITE 101
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City | RIVER FALLS
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State | WI
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Zip | 54022
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Country | US
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Telephone | 715-425-8899
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Fax | 715-425-5590
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Authorized Official
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Title or Position | CLINIC DIRECTOR VICE PRESIDENT
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Name | KAREN S LABOUNTY
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Credential | PHD LP
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Telephone | 715-425-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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