Healthcare Provider Details

I. General information

NPI: 1548475296
Provider Name (Legal Business Name): LAURA A. BOE M.A. L.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 SNELLING AVE N SUITE 230
SAINT PAUL MN
55104-6753
US

IV. Provider business mailing address

91 SNELLING AVE N SUITE 230
SAINT PAUL MN
55104-6753
US

V. Phone/Fax

Practice location:
  • Phone: 651-646-5700
  • Fax: 651-642-5909
Mailing address:
  • Phone: 651-646-5700
  • Fax: 651-642-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberLP3626
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLP3626
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberLP3626
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: