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Individual

LAURA JEAN NIELSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D., LP

Contact information

Practice address
366 SELBY AVE, SUITE 306, SAINT PAUL, MN 55102-1880
(651) 769-3360
Mailing address
2602 13TH AVE E, SAINT PAUL, MN 55109-2440
(651) 769-3360

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 4759
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP 4759
MN

Other

Enumeration date
07/02/2007
Last updated
07/10/2007
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