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Individual

DR. ANDREW LYLE JOHN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD, LP

Contact information

Practice address
3137 HENNEPIN AVE, SUITE 101, MINNEAPOLIS, MN 55408-2601
(651) 387-5697
Mailing address
4745 14TH AVE S, MINNEAPOLIS, MN 55407-3646
(651) 387-5697

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP5532
MN

Other

Enumeration date
03/18/2013
Last updated
03/18/2013
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