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General NPI Number Information
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NPI Number | 1447369673
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Entity Type | Organization
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Legal Business Name | NATALIS COUNSELING AND PSYCHOLOGY SOLUTIONS, P.A.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1600 UNIVERSITY AVE W STE 12
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City | SAINT PAUL
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State | MN
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Zip | 55104-3898
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Country | US
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Telephone | 651-330-2360
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Fax | 651-207-4000
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Provider Business Mailing Address
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Address Line | 1600 UNIVERSITY AVE W STE 12
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City | SAINT PAUL
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State | MN
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Zip | 55104-3898
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Country | US
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Telephone | 651-330-2360
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Fax | 651-207-4000
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. LISA ELSEN
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Credential |
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Telephone | 651-330-2360
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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 | 103TP2700X
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License Number State | MN
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