Individual
MS. LAURA J TRIPET DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4601 EXCELSIOR BLVD, SUITE 501A, ST LOUIS PARK, MN 55416
(952) 933-3121
(952) 933-3511
Mailing address
4601 EXCELSIOR BLVD, SUITE 501A, ST LOUIS PARK, MN 55416
(952) 933-3121
(952) 933-3511
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1396
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079N9TR
BCBS
MN
05
—
975348600
—
MN
Enumeration date
02/21/2007
Last updated
07/27/2015
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