Whiteside, Mary Jane
Whiteside, Mary Jane is an sole proprietor health care provider with primary practice located at 217 Plum St Suite 140, Red Wing MN 55066-2351. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Whiteside, Mary Jane can be contacted via phone (651) 388-4302.Contact Information
Primary practice address
217 Plum St Suite 140
Red Wing MN 55066-2351
Phone: (651) 388-4302
Fax: (651) 385-9052
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | LP3361 | Minnesota |
Profile Details
| NPI number | 1083780829 |
|---|---|
| LBN Legal business name | Whiteside, Mary Jane |
| Credentials | PHD, LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083780829 | NPPES |
| Minnesota | Other | 167752 | UCARE |
| Minnesota | Other | 108480 | UCARE |
| Minnesota | Other | 132T8WH | UCARE |
| Minnesota | Other | 1027089 | UCARE |
| Minnesota | Other | 132T7WH | UCARE |
| Minnesota | Other | 61-68825 | UCARE |
| Minnesota | Other | (NO NUMBER) | UCARE |
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