Male or Other

Dr. Bruce K. Thordal PHD

Cognitive & Behavioral Psychologist in Eagan, MN(View on Map)

Full Name

Dr. Bruce Keith Thordal PHD

NPI Number

1417091455

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/15/2007

Specialties

(Taxonomies)

Code

103TB0200X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

LP1135

Contact
Information

Purpose

Mailing
Location

Address

2870 HIGHVIEW TER
2870 HIGHVIEW TER

City

Eagan
Eagan

State

MN
MN

Postal Code

55121-1110
55121-1110

Country

US
US

Telephone Number

(612) 860-1238
(612) 860-1238

Identifiers

Identifier

201747400

Identifier State

MN

Identifier Issuer

MEDICAL ASSISTANCE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

Other Cognitive & Behavioral Psychologist in Eagan, Minnesota:

Female

Jean Johnson PSYD

Eagan, MN

Specialties: Adult Development & Aging PsychologistClinical Child & Adolescent PsychologistClinical PsychologistCognitive & Behavioral PsychologistFamily PsychologistIntellectual & Developmental Disabilities PsychologistMental Health CounselorPsychologist