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Individual

DEBORAH DECKER ROMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
(612) 676-8992
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
(612) 676-8992

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP1553
MN
103T00000X
Psychologist
LP1553
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1015100
PREFERRED ONE
MN
01
102833
UCARE
MN
01
5T337RO
BLUE CROSS BLUE SHIELD
MN
01
61-29460
MEDICA CHOICE
FM
01
61-29460
MEDICA PRIMARY
MN
01
768324
ARAZ
MN
05
842353900
MN
01
HP28951
HEALTH PARTNERS
MN
Enumeration date
10/23/2006
Last updated
10/04/2017
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