Individual
DR. KATHRYN ANNE WYMAN-CHICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D, LP
Contact information
Practice address
295 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6200
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(651) 254-7900
(651) 254-7904
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP6151
MN
103TC0700X
Clinical Psychologist
0810005336
VA
103TC0700X
Clinical Psychologist
LP6151
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/04/2009
Last updated
07/18/2023
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