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Individual

LISA RIVERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LP

Contact information

Practice address
1001 HIGHWAY 7, ROOM 217, HOPKINS, MN 55305-4723
(952) 988-4177
(952) 988-6728
Mailing address
1001 HIGHWAY 7, ROOM 217, HOPKINS, MN 55305-4723
(952) 988-4177
(952) 988-6728

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3666
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11G37RI
BLUE CROSS
MN
Enumeration date
08/11/2006
Last updated
07/08/2007
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