Provider Demographics
NPI:1275783433
Name:MURRAY, PATRICIA KATHLEEN WILSON (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:KATHLEEN WILSON
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:KATHLEEN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, LP
Mailing Address - Street 1:1755 SOUTHCROSS DR W
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-7012
Mailing Address - Country:US
Mailing Address - Phone:952-898-5020
Mailing Address - Fax:952-898-5858
Practice Address - Street 1:1755 SOUTHCROSS DR W
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-7012
Practice Address - Country:US
Practice Address - Phone:952-898-5020
Practice Address - Fax:952-898-5858
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health