Individual
DR. MARY BETH KIBORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
821 RAYMOND AVE, SUITE 200, SAINT PAUL, MN 55114-1503
(651) 645-8300
(651) 645-4603
Mailing address
821 RAYMOND AVE, SUITE 200, SAINT PAUL, MN 55114-1503
(651) 645-8300
(651) 645-4603
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4224
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103255
HEALTHPARTNERS
MN
01
—
122502
UCARE
MN
01
—
330L0KI
BCBS
MN
01
—
6157722
MEDICA/UBH
MN
Enumeration date
09/15/2006
Last updated
07/08/2007
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