Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | LP0510 | MN |
NPI | 1083782486 |
---|---|
Provider Name | Ruth Ann Schaefer |
First Address | Baxter, MN 56425-8353 |
Second Address | Brainerd, MN 56401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04RAS6558 | GAMBLING TREATMENT (01) | MN |
150062 | U CARE (01) | MN |
180POSC | BLUECROSS BLUESHIELD (01) | MN |
62-59554 | UNITED BEHAVIORAL HEALTH (01) | MN |
HP32669 | HEALTH PARTNERS (01) | MN |