Individual
DAVID BURDETTE MELLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., L.P.
Contact information
Practice address
12805 HIGHWAY 55, SUITE 211, PLYMOUTH, MN 55441-3859
(763) 550-9005
(763) 559-2118
Mailing address
12805 HIGHWAY 55, SUITE 211, PLYMOUTH, MN 55441-3859
(763) 550-9005
(763) 559-2118
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1979
MN
Other
Enumeration date
11/21/2006
Last updated
07/08/2007
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