Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | LP3782 | MN |
NPI | 1114091709 |
---|---|
Provider Name | Ms. Kathryn Naomi Hall |
First Address | Maplewood, MN 55109-5353 |
Second Address | Maplewood, MN 55109-5353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036316200 | (05) | MN |
111201 | BHP AND UCARE (01) | MN |
375G3HA | BLUE CROSS BLUE SHIELD (01) | MN |
6267153 | UBH AND MEDICA (01) | MN |
HP45668 | HEALTH PARTNERS (01) | MN |