MEDICARE: CAROL ELIZABETH ZEMPEL PHD LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LP 1320	MN

General Provider Information

NPI Number	:	1609098938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ELIZABETH ZEMPEL PHD LP

Provider Business Mailing Address
First Line	:	PO BOX 390141
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55439-0141
Country	:	US
Telephone Number	:	651-773-9100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2580 WHITE BEAR AVE N
Second Line	:	SUITE 206
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-5166
Country	:	US
Telephone Number	:	651-773-9100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	07/08/2007

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