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General NPI Number Information
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NPI Number | 1861990012
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Entity Type | Organization
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Legal Business Name | SUSAN MCPHERSON PHD ABPP LP LLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 3209 W 76TH ST STE 207
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City | EDINA
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State | MN
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Zip | 55435-5246
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Country | US
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Telephone | 952-746-4014
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Fax | 952-746-4015
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Provider Business Mailing Address
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Address Line | 4805 DREW AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55410-1741
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Country | US
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Telephone | 612-709-0589
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Fax | 952-746-4015
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUSAN MCPHERSON
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Credential | PHD
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Telephone | 952-746-4015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | LP4457
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License Number State | MN
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