Individual
BONNIE SUE MCMILLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
457 PORTLAND AVE, 3, SAINT PAUL, MN 55102-2499
(507) 202-5698
Mailing address
457 PORTLAND AVE, 3, SAINT PAUL, MN 55102-2499
(507) 202-5698
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP5384
MN
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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