Organization
TONKA LIFE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN VERNON NELSON MA LP (OWNER)
(952) 393-6280
Entity
Organization
Contact information
Practice address
3305 CASCO CIR, WAYZATA, MN 55391-9718
(952) 393-6280
(952) 471-7211
Mailing address
3305 CASCO CIR, WAYZATA, MN 55391-9718
(952) 393-6280
(952) 471-7211
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1543
MN
Other
Enumeration date
08/12/2015
Last updated
10/24/2015
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