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Clinical Neuropsychologist

Edina, Minnesota

Provider NPI: 1356348494

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
5201 EDEN AVE STE 300 EDINA, MN 55436 US
Tel: 612-743-3927  Fax: --

Business Mailing Address:
6009 CHAPEL DR  EDINA, MN 55439 US
Tel: 612-743-3927  Fax: --

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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