Provider Demographics
NPI:1013241058
Name:KALOS, PIPER SUZANNE (PHD,, LP)
Entity Type:Individual
Prefix:
First Name:PIPER
Middle Name:SUZANNE
Last Name:KALOS
Suffix:
Gender:F
Credentials:PHD,, LP
Other - Prefix:
Other - First Name:PIPER
Other - Middle Name:SUZANNE
Other - Last Name:MEYER-KALOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, LP
Mailing Address - Street 1:5775 WAYZATA BLVD
Mailing Address - Street 2:SUITE 255
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1222
Mailing Address - Country:US
Mailing Address - Phone:612-273-8710
Mailing Address - Fax:
Practice Address - Street 1:5775 WAYZATA BLVD
Practice Address - Street 2:SUITE 255
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1222
Practice Address - Country:US
Practice Address - Phone:612-273-8710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5617103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical