Individual
DR. JONATHAN KODET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD,LP
Contact information
Practice address
1850 W WAYZATA BLVD # 220, LONG LAKE, MN 55356-4413
(612) 520-1244
Mailing address
1850 W WAYZATA BLVD # 220, LONG LAKE, MN 55356-4413
(612) 520-1244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
6186
MN
103TC1900X
Counseling Psychologist
Primary
6186
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103TC0700X
—
MN
Enumeration date
09/01/2016
Last updated
03/27/2023
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