Organization
MARY BETH KIBORT, LLC
Active
Other names
Mary Beth Kibort, Psy.D., LP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY BETH KIBORT PSY.D. (CLINICAL PSYCHOLOGIST)
(651) 645-2890
Entity
Organization
Contact information
Practice address
821 RAYMOND AVE, SUITE 200, SAINT PAUL, MN 55114-1503
(651) 645-2890
(651) 645-4603
Mailing address
821 RAYMOND AVE, SUITE 200, SAINT PAUL, MN 55114-1503
(651) 645-2890
(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
—
330LOKI
BCBS
MN
01
—
6157722
MEDICA/UBH
MN
Enumeration date
09/15/2006
Last updated
08/22/2020
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