Provider Demographics
NPI:1275644247
Name:PAISER, PATRICIA J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:J
Last Name:PAISER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 LYNDALE AVE S
Mailing Address - Street 2:SUITE 150
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-4055
Mailing Address - Country:US
Mailing Address - Phone:612-243-4144
Mailing Address - Fax:
Practice Address - Street 1:7400 LYNDALE AVE S
Practice Address - Street 2:SUITE 150
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-4055
Practice Address - Country:US
Practice Address - Phone:612-243-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2189103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6169620OtherMEDICA UBH
MN4H888PAOtherBLUE CROSS BLUE SHIELD