Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | LP6078 | MN |
Y | 103TC0700X | Clinical Psychologist | LP6078 | MN |
NPI | 1003369737 |
---|---|
Provider Name | Aaron Means |
First Address | Bloomington, MN 55425-4516 |
Second Address | Saint Louis Park, MN 55416-3476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2016 |
Last Update Date | 19/12/2019 |