Organization
JACQUELYN K. WIERSMA, PH. D., LP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELYN K. WIERSMA PH. D. (CHIEF MANAGER)
(952) 938-9499
Entity
Organization
Contact information
Practice address
3931 AUBURN DR, MINNETONKA, MN 55305-5196
(952) 938-9499
(952) 938-9499
Mailing address
3931 AUBURN DR, MINNETONKA, MN 55305-5196
(952) 938-9499
(952) 938-9499
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1583
MN
Other
Enumeration date
08/16/2006
Last updated
04/05/2017
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