Provider Demographics
NPI:1326354432
Name:CABOT PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:CABOT PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M M
Authorized Official - Last Name:MULFINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:612-532-2890
Mailing Address - Street 1:7400 METRO BLVD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2316
Mailing Address - Country:US
Mailing Address - Phone:952-831-2000
Mailing Address - Fax:952-835-6134
Practice Address - Street 1:7400 METRO BLVD
Practice Address - Street 2:SUITE 216
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2316
Practice Address - Country:US
Practice Address - Phone:952-831-2000
Practice Address - Fax:952-835-6134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1003054545OtherNPI, TYPE 1