Individual
XAN K BANKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD LP
Contact information
Practice address
408 ST PETER ST, #429, ST PAUL, MN 55102
(651) 224-0614
(651) 224-5754
Mailing address
1780 EMERALD DR, NEW BRIGHTON, MN 55112
(651) 222-7628
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4635
MN
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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