Individual
DR. JAMES EDWARD BOSCARDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8085 WAYZATA BLVD, SUITE 100B, GOLDEN VALLEY, MN 55426-1453
(612) 719-0856
(651) 484-8551
Mailing address
1092 LAWNVIEW AVE, SHOREVIEW, MN 55126-8408
(612) 719-0856
(651) 484-8551
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0709
MN
103TA0700X
Adult Development & Aging Psychologist
LP0709
MN
103TC0700X
Clinical Psychologist
LP0709
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP0709
MN
103TF0000X
Family Psychologist
LP0709
MN
103TF0200X
Forensic Psychologist
LP0709
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710552500
—
MN
Enumeration date
11/03/2006
Last updated
11/18/2011
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