Individual
JENNIFER BETH MCDERMOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1919 UNIVERSITY AVE W, SUITE 200, SAINT PAUL, MN 55104-3453
(651) 266-7992
(651) 266-7854
Mailing address
1755 ASHLAND AVE, SAINT PAUL, MN 55104-6168
(651) 917-3843
(651) 266-7854
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 4569
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
692635500
—
MN
Enumeration date
01/05/2007
Last updated
07/08/2007
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