Individual
NANCY JO LEROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
7947
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6239429
MEDICA
—
Enumeration date
07/06/2006
Last updated
07/08/2007
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