Individual
JON COLOMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8669 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 379-0444
Mailing address
8669 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 379-0444
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 5165
MN
Other
Enumeration date
10/20/2005
Last updated
12/15/2011
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