Individual
PRISCILLA ELWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
3108 HENNEPIN AVE, MINNEAPOLIS, MN 55408-2619
(612) 825-4407
(612) 825-0768
Mailing address
3108 HENNEPIN AVE, MINNEAPOLIS, MN 55408-2619
(612) 825-4407
(612) 825-0768
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2997
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90758800
—
MN
Enumeration date
09/20/2006
Last updated
07/08/2007
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