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Individual

DR. KATHLEEN JEAN FEIL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LP

Contact information

Practice address
189 EGRET LN, MARINE ON SAINT CROIX, MN 55047-8641
(651) 308-5581
Mailing address
189 EGRET LN, MARINE ON SAINT CROIX, MN 55047-8641
(651) 308-5581

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4051
MN
103TR0400X
Rehabilitation Psychologist
LP4051
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
097L6FE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
07/09/2005
Last updated
09/03/2019
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