Individual
MARY ELIZABETH CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LP
Contact information
Practice address
1930 COON RAPIDS BLVD, FAMILY LIFE MENTAL HEALTH CENTER, COON RAPIDS, MN 55433
(763) 427-7964
(763) 427-7976
Mailing address
1930 COON RAPIDS BLVD, FAMILY LIFE MENTAL HEALTH CENTER, COON RAPIDS, MN 55433
(763) 427-7964
(763) 427-7976
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3985
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1024500
PREFERRED ONE
MN
01
—
123202
UCARE
—
01
—
270052697
UBH
—
01
—
286M4C0
BCBS
MN
01
—
6250882
UBH
MN
05
—
813225900
—
MN
01
—
84G92CO
BCBS
MN
01
—
HP27005
HEALTH PARTNERS
—
Enumeration date
04/07/2006
Last updated
12/10/2008
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