Individual
SALLY ROSE BRINZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LP
Contact information
Practice address
7225 FORESTVIEW LN N, MAPLE GROVE, MN 55369
(612) 978-5058
(763) 201-1095
Mailing address
14600 43RD AV N, PLYMOUTH, MN 55446
(612) 978-5058
(763) 201-1095
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2586
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6420206
MN CARE
MN
Enumeration date
09/26/2006
Last updated
07/08/2007
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