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General NPI Number Information
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NPI Number | 1801150883
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Entity Type | Individual
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Provider Name | NICHOLAS ALLEN CULP PSYD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 153 CESAR CHAVEZ ST
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City | SAINT PAUL
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State | MN
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Zip | 55107-2226
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Country | US
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Telephone | 651-222-1816
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Fax |
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Provider Business Mailing Address
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Address Line | 1550 CHARLTON ST #105
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City | WEST SAINT PAUL
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State | MN
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Zip | 55118-2947
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Country | US
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Telephone | 608-770-2787
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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