Individual
RICHARD DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(612) 433-3065
Mailing address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(612) 433-3065
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP6656
MN
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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