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Individual

MICHAEL LEE BORTEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
3450 OLEARY LN, EAGAN, MN 55123-2340
(651) 454-0114
(651) 454-3492
Mailing address
3450 OLEARY LN, EAGAN, MN 55123-2340
(651) 454-0114
(651) 454-3492

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4991
MN

Other

Enumeration date
01/07/2009
Last updated
01/07/2009
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