Individual
DR. TIMOTHY J. WOLFRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
LP 3758
MN
103TC0700X
Clinical Psychologist
Primary
LP 3758
MN
Other
Enumeration date
07/19/2007
Last updated
07/19/2007
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