Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | LP5962 | MN |
Y | 103TC0700X | Clinical Psychologist | LP5962 | MN |
NPI | 1003828278 |
---|---|
Provider Name | Dr. Christine Catherine Zych |
First Address | Marshall, MN 56258-3783 |
Second Address | Marshall, MN 56258-3783 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 21/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
441778000 | (05) | MN |