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Individual

DR. JEAN M. BIRBILIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D., L.P.

Contact information

Practice address
2721 UPPER AFTON RD E STE 101, MAPLEWOOD, MN 55119-4760
(651) 739-6167
Mailing address
2721 UPPER AFTON RD E STE 101, MAPLEWOOD, MN 55119-4760
(651) 739-6167

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0392
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
66Q90BI
BLUE CROSS BLUE SHIELD
MN
Enumeration date
03/16/2007
Last updated
07/08/2007
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