Super, Elizabeth Baraga

Super, Elizabeth Baraga is an individual health care provider with primary practice located at 325 N 33Rd Ave 103, St Cloud MN 56303. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Super, Elizabeth Baraga can be contacted via phone (320) 253-3715.

Contact Information

Primary practice address
325 N 33Rd Ave 103 St Cloud MN 56303
Phone: (320) 253-3715
Fax: (320) 252-2567
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP0453 Minnesota

Profile Details

NPI number 1427149079
LBN Legal business name Super, Elizabeth Baraga
Credentials PHD LP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427149079 NPPES
Minnesota MEDICAID 417047400

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