Provider Demographics
NPI:1982920138
Name:PATERSON, ROSLYN E (MA, LPC, BSN, RN)
Entity Type:Individual
Prefix:MS
First Name:ROSLYN
Middle Name:E
Last Name:PATERSON
Suffix:
Gender:F
Credentials:MA, LPC, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 HAMLINE AVE N
Mailing Address - Street 2:B10
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-5009
Mailing Address - Country:US
Mailing Address - Phone:651-631-0573
Mailing Address - Fax:651-631-0074
Practice Address - Street 1:2233 HAMLINE AVE N
Practice Address - Street 2:B10
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-5009
Practice Address - Country:US
Practice Address - Phone:651-631-0573
Practice Address - Fax:651-631-0074
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional