Individual
JAIME ASCENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
1155 NORTHLAND DR, MENDOTA HEIGHTS, MN 55120-1288
(612) 223-8898
Mailing address
1155 NORTHLAND DR, MENDOTA HEIGHTS, MN 55120-1288
(715) 296-7729
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6796
MN
Other
Enumeration date
08/24/2018
Last updated
05/20/2022
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