Individual
MARK L ROA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MA, LP
Contact information
Practice address
2545 CHICAGO AVE, SUITE 701, MINNEAPOLIS, MN 55404-4522
(612) 863-5327
(612) 863-2596
Mailing address
PO BOX 43, MR 10809, MINNEAPOLIS, MN 55440-0043
(612) 262-4813
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3689
MN
Other
Enumeration date
04/12/2006
Last updated
07/08/2007
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