Provider Demographics
NPI:1457409864
Name:MAGELI-MALEY, PATRICIA LYNN (MA, LP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN
Last Name:MAGELI-MALEY
Suffix:
Gender:F
Credentials:MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 HIDDEN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-2559
Mailing Address - Country:US
Mailing Address - Phone:952-938-3751
Mailing Address - Fax:952-938-0158
Practice Address - Street 1:2717 HIDDEN CREEK LN
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-2559
Practice Address - Country:US
Practice Address - Phone:952-938-3751
Practice Address - Fax:952-938-0158
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1168103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN9L708OtherBCBS
MN84296OtherHEALTH PARTNERS
MN62-99219OtherMEDICA