Provider Demographics
NPI:1518160738
Name:ADAMS, ELIZABETH N (PHD LP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:N
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PHD LP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:N
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:225 SMITH AVE N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2697
Mailing Address - Country:US
Mailing Address - Phone:651-241-5290
Mailing Address - Fax:651-241-5140
Practice Address - Street 1:225 SMITH AVE N
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2697
Practice Address - Country:US
Practice Address - Phone:651-241-5290
Practice Address - Fax:651-241-5140
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4814103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist