Kelly S Petska is a Psychologist in Minneapolis, Minnesota. Kelly S Petska practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Kelly S Petska is 1396945390. The last update date is 2007-07-19.
Kelly S Petska's current location address is One Veterans Drive, Minneapolis, Minnesota. You can contact this provider via phone number 6124673039 and fax number 6127275964. The mailing address for Kelly S Petska is One Veterans Drive, Minneapolis, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly S Petska |
|---|---|
| Address | One Veterans Drive, Minneapolis, Minnesota |
| Phone Number | 6124673039 |
| Fax Number | 6127275964 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1396945390 |
|---|---|
| Provider Enumeration Date | 2007-07-19 |
| Last Updated Date | 2007-07-19 |
Provider Mailing Address Detail
| Address | One Veterans Drive |
|---|---|
| City | Minneapolis |
| State | Minnesota (MN) |
| Post Code | 554172309 |
| Phone Number | 6124673039 |
| Fax Number | 6127275964 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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What is the unique 10-digit identifier code assigned to Kelly S Petska by the Centers for Medicare & Medicaid Services?
The Kelly S Petska has been issued the NPI (National Provider Identifier) 1396945390 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Kelly S Petska is geographically located?
The Kelly S Petska is physically situated at the following location: One Veterans Drive, Minneapolis, MN, 554172309.
What is the Kelly S Petska's area of specialization and corresponding taxonomy classification?
The Kelly S Petska's specialty field is Psychologist, and it falls under the taxonomy code 103T00000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1396945390 to Kelly S Petska?
The Kelly S Petska received its 1396945390 assignment from the Centers for Medicare & Medicaid Services on 2007-07-19.
When was the information related to Kelly S Petska most recently updated or refreshed?
The details pertaining to the Kelly S Petska, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-19.