Individual
ROBERT J ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.
Contact information
Practice address
1601 HIGHWAY 13 E, STE. 101, BURNSVILLE, MN 55337-6865
(952) 895-9200
(952) 895-1946
Mailing address
1601 HIGHWAY 13 E, STE. 101, BURNSVILLE, MN 55337-6865
(952) 895-9200
(952) 895-1946
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1486
MN
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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