| NPI | 1679673503 |
|---|---|
| Former Name | PHYLLIS A FOOTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3374) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R0691053) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-05-23 |