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General NPI Number Information
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NPI Number | 1760371611
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Entity Type | Organization
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Legal Business Name | HEATHER SVOBODA MA LP
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1678 SELBY AVE
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City | SAINT PAUL
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State | MN
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Zip | 55104-6149
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Country | US
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Telephone | 651-300-6266
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Fax |
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Provider Business Mailing Address
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Address Line | 1678 SELBY AVE
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City | SAINT PAUL
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State | MN
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Zip | 55104-6149
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Country | US
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Telephone | 651-300-6266
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | HEATHER L SVOBODA
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Credential | MA LP
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Telephone | 651-300-6266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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