Individual
ROBERT O'NEILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 828-7379
(218) 828-7390
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 828-7379
(218) 828-7390
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2717
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111781
UCARE OF MN
MN
01
—
9H118ON
BCBS OF MN
MN
Enumeration date
11/30/2006
Last updated
07/08/2007
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