Individual
MR. RICHARD WADE CHAMBERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
12 BRIDGE SQ STE 207, ANOKA, MN 55303
(952) 693-8220
Mailing address
12 BRIDGE SQ, STE 207, ANOKA, MN 55303
(952) 693-8220
(763) 712-9200
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1313
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
817981600
—
MN
Enumeration date
05/02/2006
Last updated
08/22/2018
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