Individual
MARY E CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LP
Contact information
Practice address
301 SOUTH DIVISION ST, NORTHFIELD, MN 55057
(507) 650-4127
(507) 650-9261
Mailing address
301 SOUTH DIVISION ST, NORTHFIELD, MN 55057
(507) 650-4127
(507) 650-9261
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3563
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60G07CA
BLUE CROSS BLUE SHIELD
MN
01
—
6252382
MEDICA
MN
Enumeration date
11/08/2005
Last updated
07/08/2007
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