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Individual

MR. JAMIE MCDONELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA LP

Contact information

Practice address
241 CLEVELAND AVE S, SAINT PAUL, MN 55105-1208
(651) 699-7051
(651) 699-7052
Mailing address
241 CLEVELAND AVE S, SAINT PAUL, MN 55105-1208
(651) 699-7051
(651) 699-7052

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP3798
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
79B63MC
BLUE CROSS BLUE SHIELD
MN
Enumeration date
04/12/2007
Last updated
07/09/2007
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