| Katherine Kegan, Phd | |
|
314 Clifton Ave Suite 103 Minneapolis MN 55403-3235 | |
| (612) 870-0980 | |
| (612) 872-3686 |
| Full Name | Katherine Kegan, Phd |
|---|---|
| Speciality | Psychologist |
| Location | 314 Clifton Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Katherine Anne Kegan (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6128700980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Kegan, Phd 314 Clifton Ave Suite 103 Minneapolis MN 55403-3235 Ph: (612) 870-0980 | Katherine Kegan, Phd 314 Clifton Ave Suite 103 Minneapolis MN 55403-3235 Ph: (612) 870-0980 |
| NPI Number | 1477620425 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8325196470 |
|---|---|
| Medicare Enrollment ID | O20090430000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477620425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP0162 (Minnesota) | Primary |
| Provider Name | Katherine A Kegan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649328014 PECOS PAC ID: 8426106576 Enrollment ID: I20090430000061 |
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