Provider Demographics
NPI:1821140773
Name:TRUMAN, SEAN DAVID (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:DAVID
Last Name:TRUMAN
Suffix:
Gender:M
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 CLEVELAND AVE S
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-1208
Mailing Address - Country:US
Mailing Address - Phone:651-699-5352
Mailing Address - Fax:
Practice Address - Street 1:241 CLEVELAND AVE S
Practice Address - Street 2:SUITE A-1
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1208
Practice Address - Country:US
Practice Address - Phone:651-699-5352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 4551103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical