Individual
DR. JOHN NOLEN O'NEIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7101 YORK AVE S STE 301, EDINA, MN 55435-4469
(612) 223-7103
(952) 681-2792
Mailing address
7101 YORK AVE S STE 301, EDINA, MN 55435-4469
(612) 223-7103
(952) 681-2792
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4307
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013764200
—
MN
01
—
169041
UCARE
MN
01
—
49F690N
BLUE CROSS BLUE SHIELD
MN
01
—
6169449
MEDICA
—
01
—
HP40630
HEALTH PARTNERS
MN
Enumeration date
01/30/2007
Last updated
12/25/2019
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