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General NPI Number Information
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NPI Number | 1457414179
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Entity Type | Individual
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Provider Name | KATHRYN MARY MCALISTER MA LP
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 06/26/2009
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Provider Practice Location Address
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Address Line | 1700 NORTH BROADWAY SUITE 102
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City | ROCHESTER
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State | MN
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Zip | 55906-4144
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Country | US
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Telephone | 507-280-9205
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Fax | 507-280-9208
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Provider Business Mailing Address
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Address Line | 1700 NORTH BROADWAY SUITE 102
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City | ROCHESTER
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State | MN
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Zip | 55906-4144
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Country | US
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Telephone | 507-280-9205
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Fax | 507-280-9208
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | LP4026
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License Number State | MN
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