Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | R0481 | MO |
NPI | 1083945356 |
---|---|
Provider Name | Rosean Bishop |
First Address | Mankato, MN 56001-4752 |
Second Address | Mankato, MN 56001-4752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2010 |
Last Update Date | 27/10/2020 |