Kate Kavanaugh, Ma Lp, PA

NPI #1396714234 in Eden Prairie, Minnesota

Provider Information

NPI Number: 1396714234
Entity Type: Organization
Organization Name: Kate Kavanaugh, Ma Lp, PA
Primary Specialty: Psychologist - Clinical
Enumeration Date: Mar 14, 2006
Last Updated: Jun 3, 2014

Practice Location

Address: 9531 W. 78TH STREET
Address 2: SUITE 110
City: Eden Prairie
State: Minnesota
ZIP Code: 55344
Phone: (952) 893-9791

Authorized Official

Name: MS. KATHLEEN MARIE KAVANAUGH, MA LP
Title: PRESIDENT
Phone: (952) 893-9791

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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