Basic Information
| Provider Information | |||||||||
| NPI: | 1518160738 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | |||||||||
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| Credential: | PHD LP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ADAMS | ||||||||
| OtherFirstName: | ELIZABETH | ||||||||
| OtherMiddleName: | N | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 225 SMITH AVE N | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551022697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512415290 | ||||||||
| FaxNumber: | 6512415140 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 SMITH AVE N | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551022697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512415290 | ||||||||
| FaxNumber: | 6512415140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2007 | ||||||||
| LastUpdateDate: | 05/15/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | LP4814 | MN | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.