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General NPI Number Information
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NPI Number | 1770173130
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Entity Type | Organization
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Legal Business Name | MARKANDA CLINIC FOR INTEGRATED PSYCHOLOGY
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Dates
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Enumeration Date | 01/20/2021
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 7009 WHITEHALL RD
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City | SHAKOPEE
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State | MN
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Zip | 55379-8016
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Country | US
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Telephone | 612-655-6047
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Fax |
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Provider Business Mailing Address
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Address Line | 7009 WHITEHALL RD
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City | SHAKOPEE
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State | MN
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Zip | 55379-8016
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Country | US
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Telephone | 612-655-6047
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SONAL MARKANDA
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Credential |
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Telephone | 612-655-6047
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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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