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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

NPI # 1316047517
LBN Legal business name MANKATO CHILD PSYCHOLOGY CLINIC PA
Authorized official SYLVIA ASHLEY-CAMERON - (PRESIDENT OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN License # LP1391
Other 42552AS BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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