Individual
DR. RICHARD MARK WEINBERGER SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSED, LP
Contact information
Practice address
4027 COUNTY ROAD 25, MINNEAPOLIS, MN 55416-2629
(612) 925-6033
(612) 925-8496
Mailing address
4240 PARK GLEN RD, ST LOUIS PARK, MN 55416-5427
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1310
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
380248500
MEDICAL ASSISTANCE
MN
Enumeration date
09/26/2006
Last updated
01/25/2022
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