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Individual

RYAN MICHAEL ENGDAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD, LP

Contact information

Practice address
1406 6TH AVENUE NORTH, ST. CLOUD HOSPITAL, ST. CLOUD, MN 56303-1901
(320) 251-2700
(320) 229-5109
Mailing address
1900 CENTRA CARE CIRCLE #2475, CENTRA CARE HEALTH PLAZA, ST. CLOUD, MN 56303-5000
(320) 229-5199
(320) 229-5109

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
Primary
LP5519
MN

Other

Enumeration date
05/09/2011
Last updated
10/12/2012
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