TIM RICHARD PORTINGA

PLYMOUTH, MN
NPI1609924216
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist Clinical
(Licence: MN  LP4699)
Enumeration Date2007-01-08
Last Update Date2007-07-08
Business Address
TIM RICHARD PORTINGA PSYD LP
11505 36TH AVE N
PLYMOUTH, MN 55441-2304
Phone number: 763-509-3818
Mailing Address
TIM RICHARD PORTINGA PSYD LP
11505 36TH AVE N
PLYMOUTH, MN 55441-2304
Phone number: 763-509-3818
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