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General NPI Number Information
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NPI Number | 1215055587
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Entity Type | Individual
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Provider Name | DAWN ELIZABETH MCCLELLAND PHD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1660 S HWY 100 #428
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City | ST LOUIS PARK
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State | MN
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Zip | 55416
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Country | US
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Telephone | 763-541-1973
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Fax | 952-938-6969
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Provider Business Mailing Address
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Address Line | 5211 MALIBU DR
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City | EDINA
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State | MN
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Zip | 55436
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Country | US
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Telephone | 763-541-1973
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Fax | 952-938-6969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP3008
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License Number State | MN
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