Individual
STACEY JUNGHANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LP
Contact information
Practice address
5625 CENEX DR, INVER GROVE HEIGHTS, MN 55077-1724
(651) 552-2600
(651) 552-2614
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(651) 552-2600
(651) 552-2614
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4106
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022878
P1
MN
01
—
124596
UC
MN
01
—
20D41JU
BCBS
MN
05
—
285418000
—
MN
01
—
30594
HP
MN
01
—
62-62375
UBH
MN
Enumeration date
07/27/2006
Last updated
11/02/2016
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