| Clinic For Attention, Learning, And Memory, Pa | |
|
1409 Willow St Suite 600 Minneapolis MN 55403-2269 | |
| (612) 872-9072 | |
| (612) 872-8605 |
| Full Name | Clinic For Attention, Learning, And Memory, Pa |
|---|---|
| Speciality | Psychologist |
| Location | 1409 Willow St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Gary Gene Johnson (OWNER & PRESIDENT) |
| Authorized Official Contact | 6124193266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinic For Attention, Learning, And Memory, Pa 1409 Willow St #600 Minneapolis MN 55403 Ph: (612) 872-2343 | Clinic For Attention, Learning, And Memory, Pa 1409 Willow St Suite 600 Minneapolis MN 55403-2269 Ph: (612) 872-9072 |
| NPI Number | 1053614131 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 12/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053614131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP1794 (Minnesota) | Primary |
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