Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | LP2178 | MN |
NPI | 1063443620 |
---|---|
Provider Name | Richard Colund |
First Address | Chanhassen, MN 55317-4605 |
Second Address | Chanhassen, MN 55317-4605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 08/07/2007 |