Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRUCE KEITH THORDAL, PHD
Active Sole ProprietorDR. BRUCE KEITH THORDAL, PHD is a Cognitive & Behavioral Psychologist healthcare provider located in EAGAN, Minnesota. NPI 1417091455 is currently active in the NPPES registry. Verify at CMS.
Cognitive & Behavioral Psychologist · EAGAN, MN
Registration Details
- NPI Number
- 1417091455
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 15, 2007 (19.504969700529 yrs)
- Last Updated
- Jul 8, 2007
- License
-
LP1135 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2870 HIGHVIEW TEREAGAN, MN, 551211110Browse MN providers · Browse ZIP 55121
- Phone
- 6128601238
- Fax
- 9529481277
- Primary Specialty
-
Cognitive & Behavioral Psychologist
103TB0200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.