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Individual

ELDON JAMES BRUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D., LP, LMFT

Contact information

Practice address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2327
MN
106H00000X
Marriage & Family Therapist
0642
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
090547000
MN
Enumeration date
07/07/2006
Last updated
02/27/2017
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