Individual
DR. AMANDA ROSE DONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
11855 ULYSSES ST NE, BLAINE, MN 55434-3947
(763) 762-9241
Mailing address
10611 BALTIMORE ST NE UNIT 490412, MINNEAPOLIS, MN 55449-9930
(651) 279-3963
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
CC00630
MN
103TC0700X
Clinical Psychologist
Primary
LP6790
MN
Other
Enumeration date
12/29/2020
Last updated
12/27/2022
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