Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1003474123 |
---|---|
Provider Name | Elizabeth Ann Quinby |
First Address | Mankato, MN 56001-1718 |
Second Address | Mankato, MN 56001-1718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2019 |
Last Update Date | 04/06/2019 |