Individual
MR. MICHAEL LEE KOGAN-WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1600 UNIVERSITY AVE W STE 505, SAINT PAUL, MN 55104-3825
(651) 645-0980
(651) 645-3534
Mailing address
616 E 132ND ST, BURNSVILLE, MN 55337-3811
(952) 736-7780
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2974
MN
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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