Individual
MR. JAMIE MICHAEL MERSOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9245 QUANTRELLE AVE NE, OTSEGO, MN 55330-0168
(763) 746-9492
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(818) 391-0602
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
XXXXXXXXXXXXXXX
MN
Other
Enumeration date
05/06/2022
Last updated
05/06/2022
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