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Contact Information

LIFE SKILLS INSTITUTE & CLINIC, INC.
3937 ORCHID LN N
PLYMOUTH, MN55446-3281
 Phone: 763-476-1031
 Fax: 763-476-0181
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIFE SKILLS INSTITUTE CLINIC INC · (Female)

NPI # 1528145281
Status Active
Credentials
Entity Individual
Enumeration date 11/01/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # LP0148
  • MN Other 05915GR BLUE CROSS BLUE SHIELD
  • MN Other 6181110 MEDICA PROVIDER ID
  • MN Other 41147 PREFERRED ONE PROV ID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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