Healthcare Provider Details

I. General information

NPI: 1821934480
Provider Name (Legal Business Name): GRETA CONLON PHD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRETA KOS PHD, LP

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 AMERICAN BLVD E STE 8
BLOOMINGTON MN
55425-1230
US

IV. Provider business mailing address

1801 AMERICAN BLVD E STE 8
BLOOMINGTON MN
55425-1230
US

V. Phone/Fax

Practice location:
  • Phone: 952-767-2267
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP7367
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: