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General NPI Number Information
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NPI Number | 1639328065
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Entity Type | Organization
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Legal Business Name | ERIC FELSCH, PSY.D., LP, LLC
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 110 2ND ST S SUITE 303
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City | WAITE PARK
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State | MN
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Zip | 56387-1662
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Country | US
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Telephone | 320-217-6012
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Fax |
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Provider Business Mailing Address
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Address Line | 110 2ND ST S SUITE 303
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City | WAITE PARK
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State | MN
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Zip | 56387-1662
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Country | US
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Telephone | 320-217-6012
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC LESTER FELSCH
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Credential | PSY.D., LP
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Telephone | 320-217-6012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LP4514
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License Number State | MN
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