Organization
DOCTOR V LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISCHELLE L VIETANEN PSYD (OWNER)
(218) 398-3502
Entity
Organization
Contact information
Practice address
2002 CROMELL DRIVE, HOPE HOUSE OF ITASCA COUNTY, LAPRAIRIE, MN 55744
(218) 398-3502
(218) 326-4390
Mailing address
2002 CROMELL DRIVE, LAPRAIRIE, MN 55744
(218) 398-3502
(218) 626-4390
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5574
MN
Other
Enumeration date
06/13/2014
Last updated
07/14/2014
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