Organization
RICHARD A KOLOTKIN PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A KOLOTKIN PHD (PRESIDENT)
(701) 280-2484
Entity
Organization
Contact information
Practice address
403 CENTER AVE, SUITE 601, MOORHEAD, MN 56560-1975
(701) 280-2484
(701) 232-2220
Mailing address
403 CENTER AVE, SUITE 601, MOORHEAD, MN 56560-1975
(701) 280-2484
(701) 232-2220
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MN LP
PSYCHOLOGIST CLINICAL
MN
01
—
ND 108
PSYCHOLOGIST CLINICAL
ND
Enumeration date
02/02/2007
Last updated
08/22/2020
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