Organization
COMMUNITY PSYCHOLOGY OF MINNESOTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY LEE KINDER L.P., L.M.F.T. (CEO)
(651) 647-4944
Entity
Organization
Contact information
Practice address
1895 LAUREL AVE, SAINT PAUL, MN 55104-5938
(651) 647-4944
(651) 646-6176
Mailing address
1895 LAUREL AVE, SAINT PAUL, MN 55104-5938
(651) 647-4944
(651) 646-6176
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4383
MN
106H00000X
Marriage & Family Therapist
392
MN
Other
Enumeration date
01/11/2011
Last updated
01/11/2011
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