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Individual

MICHAEL VANCLEVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA LP LADC

Contact information

Practice address
2550 UNIVERSITY AVE W, SUITE 435S, SAINT PAUL, MN 55114-1052
(651) 647-1900
(651) 647-1861
Mailing address
1374 SHELDON ST, SAINT PAUL, MN 55108-2411
(651) 647-5602
(952) 883-5395

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3135
MN

Other

Enumeration date
02/08/2006
Last updated
07/08/2007
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