Provider Demographics
NPI:1093183436
Name:PIERPONT, ELIZABETH IRENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:IRENE
Last Name:PIERPONT
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Gender:F
Credentials:PHD
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Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MAYO MAIL CODE 486
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:MAYO MAIL CODE 486
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-624-8422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist