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Individual

THOMAS RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LP

Contact information

Practice address
2550 UNIVERSITY AVE W, SUITE 229NORTH, SAINT PAUL, MN 55114-1052
(651) 645-3115
(651) 645-2752
Mailing address
2550 UNIVERSITY AVE W, SUITE 229NORTH, SAINT PAUL, MN 55114-1052
(651) 645-3115
(651) 645-2752

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4092
MN

Other

Enumeration date
09/29/2010
Last updated
09/29/2010
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