Individual
DR. JESSICA L. PISHNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
3033 CAMPUS DR STE W225, PLYMOUTH, MN 55441-2752
(999) 999-9999
Mailing address
3033 CAMPUS DR STE W225, PLYMOUTH, MN 55441-2752
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5485
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680003367
MEDICARE ID
MN
Enumeration date
12/30/2009
Last updated
08/24/2021
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