Individual
DR. JUSTIN COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
7236 FORESTVIEW LANE N., MAPLE GROVE, MN 55369
(763) 416-4167
(763) 416-4137
Mailing address
521 2ND ST SE, # 100, MINNEAPOLIS, MN 55414-2290
(651) 235-8321
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP5543
MN
Other
Enumeration date
12/09/2008
Last updated
04/18/2014
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