| Richard A Kolotkin Phd Pa | |
|
403 Center Ave Suite 601 Moorhead MN 56560-1975 | |
| (701) 280-2484 | |
| (701) 232-2220 |
| Full Name | Richard A Kolotkin Phd Pa |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 403 Center Ave, Moorhead, Minnesota |
| Authorized Official Name and Position | Richard A Kolotkin (PRESIDENT) |
| Authorized Official Contact | 7012802484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard A Kolotkin Phd Pa 403 Center Ave Suite 601 Moorhead MN 56560-1975 Ph: (701) 280-2484 | Richard A Kolotkin Phd Pa 403 Center Ave Suite 601 Moorhead MN 56560-1975 Ph: (701) 280-2484 |
| NPI Number | 1841338548 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841338548 | NPI | - | NPPES |
| ND 108 | Other | ND | PSYCHOLOGIST CLINICAL |
| MN LP | Other | MN | PSYCHOLOGIST CLINICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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