Organization
THOMAS PAUL CARRILLO PH.D.,L.P.P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS PAUL CARRILLO PH.D. (PRESIDENT)
(612) 288-5000
Entity
Organization
Contact information
Practice address
400 S 4TH ST, 854, MINNEAPOLIS, MN 55415-1411
(612) 288-5000
(612) 288-5002
Mailing address
400 S 4TH ST, 854, MINNEAPOLIS, MN 55415-1411
(612) 288-5000
(612) 288-5002
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0339
MN
Other
Enumeration date
06/22/2008
Last updated
06/22/2008
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