Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | LP4540 | MN |
NPI | 1104868421 |
---|---|
Provider Name | Tricia L. Aiken |
First Address | Mankato, MN 56001-3605 |
Second Address | Mankato, MN 56001-3605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 05/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060H0AS | MN BLUE CROSS GROUP # (01) | MN |
755295500 | (05) | MN |
84732 | HEALTH PARTNERS GR# (01) | MN |