| Organization Name: | MIGDAL PSYCHOLOGICAL SERVICES, LLC |
| NPI Number: | 1235531815 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORI E. MIGDAL (OWNER) |
| Mailing Address: | 8519 Eagle Point Blvd Suite 150 Lake Elmo |
| State: | MN US |
| Postal Code: | 550428629 |
| Phone Number: | 6513959442 |
| Fax Number: | |
| NPI Enumeration Date: | 09/25/2014 |
| NPI Last Update Date: | 09/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP5218 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |