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Contact Information

MANKATO CHILD PSYCHOLOGY CLINIC PA
220 E MAIN STREET
SUITE 204 MANKATO CHILD PSYCHOLOGY CLINIC PA
MANKATO, MN56001
 Phone: 507-345-5590
 Fax: 507-345-3550
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MANKATO CHILD PSYCHOLOGY CLINIC PA · (Female)

NPI # 1316047517
Status Active
Credentials
Entity Individual
Enumeration date 09/25/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • MN License # LP1391
  • Other 42552AS BLUE CROSS BLUE SHIELD
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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