Organization
CLINICAL AND FORENSIC PSYCHOLOGY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES HARLAN GILBERTSON PHD (PRESIDENT)
(612) 581-6655
Entity
Organization
Contact information
Practice address
2677 INNSBRUCK DR, SUITE D, SAINT PAUL, MN 55112-6395
(612) 581-6655
(651) 633-9485
Mailing address
POST OFFICE BOX 67, BARNUM, MN 55707
(612) 581-6655
(651) 633-9485
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LP1768
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420247300
—
MN
Enumeration date
03/25/2009
Last updated
03/25/2009
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