Individual
MS. KATIE LYN RICKORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
8421 WAYZATA BLVD STE 305, ST LOUIS PARK, MN 55426-1395
(612) 619-0086
(651) 344-0820
Mailing address
700 COMMERCE DR STE 290, WOODBURY, MN 55125-9256
(612) 619-0086
(651) 344-0820
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 5109
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HP59141
HEALTHPARTNERS
MN
Enumeration date
01/02/2007
Last updated
01/30/2017
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