Individual
HEATHER LANAE BAJEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1024 7TH AVE, WORTHINGTON, MN 56187-2287
(507) 376-4141
(507) 376-4494
Mailing address
216 E LUVERNE ST, PO BOX 686, LUVERNE, MN 56156-1610
(507) 283-9511
(507) 283-9514
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4893
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360608000
—
MN
Enumeration date
02/11/2008
Last updated
05/09/2008
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