Individual
DAVID RANDAL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
PARK NICOLLET CLINIC IDC, 3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416
(952) 993-3393
(952) 993-1302
Mailing address
6465 WAYZATA BLVD, ST E 315, ST LOUIS PARK, MN 55426-1728
(952) 993-6450
(952) 993-0300
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2548
MN
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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