Organization
LIFE SKILLS INSTITUTE & CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARGARET GREEN EDD, LP (LICENSEED PSYCHOLOGIST)
(763) 476-1031
Entity
Organization
Contact information
Practice address
3937 ORCHID LN N, PLYMOUTH, MN 55446-3281
(763) 476-1031
(763) 476-0181
Mailing address
3937 ORCHID LN N, PLYMOUTH, MN 55446-3281
(763) 476-1031
(763) 476-0181
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0148
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05915GR
BLUE CROSS BLUE SHIELD
MN
01
—
41147
PREFERRED ONE PROV ID
MN
01
—
6181110
MEDICA PROVIDER ID
MN
Enumeration date
11/01/2006
Last updated
08/22/2020
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