Individual
THEODORE PERKINS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
3800 PARK NICOLLET BLVD, PARK NICOLLET CLINIC SLP, ST LOUIS PARK, MN 55416
(952) 993-5911
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
(952) 993-6450
(952) 993-0300
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LADC 300151
MN
103T00000X
Psychologist
LP3590
MN
Other
Enumeration date
11/30/2005
Last updated
07/08/2007
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