| Mankato Child Psychology Clinic Pa | |
|
220 E Main Street Suite 204 Mankato Child Psychology Clinic Pa Mankato MN 56001 | |
| (507) 345-5590 | |
| (507) 345-3550 |
| Full Name | Mankato Child Psychology Clinic Pa |
|---|---|
| Speciality | Psychologist |
| Location | 220 E Main Street, Mankato, Minnesota |
| Authorized Official Name and Position | Sylvia Elaine Ashley-cameron (PRESIDENT OWNER) |
| Authorized Official Contact | 5073455590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mankato Child Psychology Clinic Pa 220 E Main Street Suite 204 Mankato Child Psychology Clinic Pa Mankato MN 56001 Ph: (507) 345-5590 | Mankato Child Psychology Clinic Pa 220 E Main Street Suite 204 Mankato Child Psychology Clinic Pa Mankato MN 56001 Ph: (507) 345-5590 |
| NPI Number | 1316047517 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316047517 | NPI | - | NPPES |
| 42552AS | Other | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP1391 (Minnesota) | Primary |
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