Individual
DR. LENI DE MIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
430 OAK GROVE STREET, #230, MINNEAPOLIS, MN 55403-3259
(612) 870-0230
Mailing address
430 OAK GROVE STREET, #230, MINNEAPOLIS, MN 55403-3259
(612) 870-0230
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0922
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3492562
MN PROV TAX NO
MN
Enumeration date
03/22/2007
Last updated
07/08/2007
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