Bonnie L Carlson-green PHD LP

NPI 1063471506 - Clinical Neuropsychologist - 103G00000X

NPI Details
NPI 1063471506
Gender Female
Enumeration Date 03/22/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
347 NORTH SMITH AVENUE
CHILDRENS SPECIALTY CLINIC PSYCHOLOGICAL SERVICES STPL
ST PAUL MN, 55102, US
Phone (651) 220-6720
Fax (651) 220-6707
Business Location
2910 CENTRE POINTE DRIVE
35-121A CHILDRENS HEALTH CARE
ROSEVILLE MN, 55113, US
Phone (651) 855-2327
Fax (651) 855-2310
Toxanomy
Taxonomy Code 103G00000X
License State Minnesota
License Number LP3309
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According to our database, Bonnie L Carlson-green PHD LP NPI is 1063471506, taxonomy code is 103G00000X and license number is LP3309, license state is located at Minnesota. Bonnie L Carlson-green PHD LP physically located at 347 North Smith Avenue, St Paul MN, 55102. NPI Number Bonnie L Carlson-green PHD LP has the Individual type.

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1063471506 NPI number is provided on an as is basis without warranty of any kind. 1063471506 is maintained by the National Plan & Provider Enumeration System. The contents of Bonnie L Carlson-green PHD LP are for informational purposes only.