Individual
DR. MARIE WELBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1516 W LAKE ST, MINNEAPOLIS, MN 55408-2554
(612) 824-4123
(952) 829-8005
Mailing address
PO BOX 24625, EDINA, MN 55424-0625
(612) 824-4123
(952) 829-8005
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4371
MN
103TC0700X
Clinical Psychologist
PSY15185
CA
Other
Enumeration date
02/24/2007
Last updated
07/08/2007
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