Individual
MS. JANE M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
40 11TH ST, CLOQUET, MN 55720-1817
(218) 879-4559
(218) 879-0282
Mailing address
1401 E 1ST ST, DULUTH, MN 55805-2407
(218) 728-4491
(218) 728-4404
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2925
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264327800
—
MN
Enumeration date
07/02/2006
Last updated
06/29/2015
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