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General NPI Number Information
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NPI Number | 1669484705
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Entity Type | Individual
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Provider Name | COLLEEN O'LEARY M.S., L.P.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 122 STONY POINT RD
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City | COURTLAND
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State | MN
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Zip | 56021-9738
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Country | US
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Telephone | 507-359-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 122 STONY POINT RD
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City | COURTLAND
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State | MN
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Zip | 56021-9738
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Country | US
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Telephone | 507-359-5439
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP2982
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License Number State | MN
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