Individual
MS. MARY A GOSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 520-1396
Mailing address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 4037
MN
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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