Thomas Paul Carrillo Ph.d.,l.p.p.a. | |
400 S 4th St 854 Minneapolis MN 55415-1411 | |
(612) 288-5000 | |
(612) 288-5002 |
Full Name | Thomas Paul Carrillo Ph.d.,l.p.p.a. |
---|---|
Speciality | Psychologist |
Location | 400 S 4th St, Minneapolis, Minnesota |
Authorized Official Name and Position | Thomas Paul Carrillo (PRESIDENT) |
Authorized Official Contact | 6122885000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Thomas Paul Carrillo Ph.d.,l.p.p.a. 400 S 4th St 854 Minneapolis MN 55415-1411 Ph: (612) 288-5000 | Thomas Paul Carrillo Ph.d.,l.p.p.a. 400 S 4th St 854 Minneapolis MN 55415-1411 Ph: (612) 288-5000 |
NPI Number | 1154582138 |
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Provider Enumeration Date | 06/22/2008 |
Last Update Date | 06/22/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154582138 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | LP0339 (Minnesota) | Primary |
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