Organization
LIFE DYNAMICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK JORENBY MA, LP (LICENSED PSYCHOLOGIST/OWNER)
(952) 226-2641
Entity
Organization
Contact information
Practice address
6885 BOUDIN ST NE, SUITE 100, PRIOR LAKE, MN 55372-1432
(952) 226-2641
(952) 226-2641
Mailing address
6885 BOUDIN ST NE, SUITE 100, PRIOR LAKE, MN 55372-1432
(952) 226-2641
(952) 226-2641
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3631
MN
Other
Enumeration date
04/21/2013
Last updated
04/21/2013
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