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General NPI Number Information
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NPI Number | 1922660083
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Entity Type | Organization
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Legal Business Name | EXMAN PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 3820 CLEVELAND AVE N STE 400
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City | ARDEN HILLS
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State | MN
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Zip | 55112-3297
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Country | US
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Telephone | 651-362-0155
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Fax |
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Provider Business Mailing Address
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Address Line | 5123 253RD AVE NW
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City | ISANTI
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State | MN
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Zip | 55040-4203
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Country | US
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Telephone | 651-343-3025
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. AMANDA EXMAN
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Credential | PSY.D.
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Telephone | 651-362-0155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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