Provider Demographics
NPI:1972780708
Name:STRICKLAND, PAUL O (MA, LP)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:O
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:MA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 SCHEFFER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1455
Mailing Address - Country:US
Mailing Address - Phone:651-442-3204
Mailing Address - Fax:
Practice Address - Street 1:1735 SCHEFFER AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1455
Practice Address - Country:US
Practice Address - Phone:651-442-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3753103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling