Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | LP6098 | MN |
NPI | 1124569066 |
---|---|
Provider Name | Adriana Marie Youssef |
First Address | Minneapolis, MN 55404-3959 |
Second Address | Minneapolis, MN 55404-3959 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2017 |
Last Update Date | 13/10/2020 |