Individual
DR. ROBERT ALAN MANTELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD, L.P.
Contact information
Practice address
408 SAINT PETER ST, STE 429, SAINT PAUL, MN 55102-1130
(651) 224-0614
(651) 224-5754
Mailing address
408 SAINT PETER ST, STE 429, SAINT PAUL, MN 55102-1130
(651) 224-0614
(651) 224-5754
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4386
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
710S8MA
BC/BS
—
Enumeration date
08/01/2005
Last updated
07/08/2007
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