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1902133440
THYRA ANNE FOSSUM
SAINT PAUL, MN
NPI
1902133440
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MN LP4703)
Enumeration Date
2009-11-04
Last Update Date
2015-06-30
Business Address
Dr. THYRA ANNE FOSSUM Ph.D.
1595 SELBY AVE SUITE 109
SAINT PAUL, MN 55104-6221
Phone number: 612-229-8198
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Mailing Address
Dr. THYRA ANNE FOSSUM Ph.D.
1595 SNELLING AVENUE SUITE 109
SAINT PAUL, MN 55104
Phone number: 612-229-8198
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