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General NPI Number Information
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NPI Number | 1821236449
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Entity Type | Individual
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Provider Name | NANCY ANN BINFORD PH.D
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Gender | Female
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 2042 WOODDALE DR STE 130
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City | WOODBURY
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State | MN
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Zip | 55125-4398
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Country | US
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Telephone | 651-558-7554
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Fax |
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Provider Business Mailing Address
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Address Line | 2042 WOODDALE DR STE 130
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City | WOODBURY
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State | MN
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Zip | 55125-4398
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Country | US
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Telephone | 651-558-7554
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP6019
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | LP6019
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License Number State | MN
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