Individual
MR. RICHARD JOHN SCANLON JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.A., L.P.
Contact information
Practice address
6542 REGENCY LN, #212, EDEN PRAIRIE, MN 55344-7847
(612) 669-3759
Mailing address
8120 165TH ST E, PRIOR LAKE, MN 55372-4100
(612) 669-3759
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2556
MN
Other
Enumeration date
09/01/2005
Last updated
07/08/2007
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