Individual
DR. PHILIP DAVID IMHOLTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3259 ZARTHAN AVE S, MINNEAPOLIS, MN 55416-2062
(320) 828-0864
Mailing address
3259 ZARTHAN AVE S, MINNEAPOLIS, MN 55416-2062
(320) 828-0864
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
004270
CT
103TC1900X
Counseling Psychologist
Primary
LP6876
MN
Other
Enumeration date
10/04/2019
Last updated
12/07/2022
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