Individual
DR. GARRY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
2345 ARIEL ST NORTH MAIL STOP 13601A, MAPLEWOOD, MN 55109
(651) 254-4793
Mailing address
514 SAXON DR, ELKO NEW MARKET, MN 55054-4712
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5643
MN
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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