Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1124533617 |
---|---|
Provider Name | Rebecca A Murphy |
First Address | Woodbury, MN 55125-7611 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2017 |
Last Update Date | 17/03/2018 |