Provider Demographics
NPI:1124702071
Name:OPEN HANDS PSYCHOLOGICAL AND CONSULTING SERVICES
Entity type:Organization
Organization Name:OPEN HANDS PSYCHOLOGICAL AND CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MARANDA
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:520-987-3196
Mailing Address - Street 1:4536 58TH AVE N APT 239
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2994
Mailing Address - Country:US
Mailing Address - Phone:520-987-3196
Mailing Address - Fax:
Practice Address - Street 1:4536 58TH AVE N APT 239
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-2994
Practice Address - Country:US
Practice Address - Phone:520-987-3196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center