Individual
BRENT ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3400
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6175
—
Other
Enumeration date
11/30/2017
Last updated
03/12/2021
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