Jackie Sue Niemand in Stillwater - Clinical Child & Adolescent
Jackie Sue Niemand - NPI 1417958893
Jackie Sue Niemand is a Clinical Child & Adolescent in Stillwater, Minnesota. Jackie Sue Niemand practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Jackie Sue Niemand is 1417958893. The last update date is 2021-02-10.
Jackie Sue Niemand's current location address is 6381 Osgood Ave N Ste 8, Stillwater, Minnesota. You can contact this provider via phone number 6512759680 and fax number 6514309296. The mailing address for Jackie Sue Niemand is 6381 Osgood Ave N Ste 8, Stillwater, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackie Sue Niemand |
|---|---|
| Address | 6381 Osgood Ave N Ste 8, Stillwater, Minnesota |
| Phone Number | 6512759680 |
| Fax Number | 6514309296 |
| Sole Proprietor | Y |
| Credentials | LIC PSYCH |
NPI Number Detail
| NPI Number | 1417958893 |
|---|---|
| Provider Enumeration Date | 2005-08-09 |
| Last Updated Date | 2021-02-10 |
Provider Mailing Address Detail
| Address | 6381 Osgood Ave N Ste 8 |
|---|---|
| City | Stillwater |
| State | Minnesota (MN) |
| Post Code | 550826182 |
| Phone Number | 6512759680 |
| Fax Number | 6514309296 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Child & Adolescent |
|---|---|
| Taxonomy | 103Tc2200X |
| Licence No | LP3518 |
|
Definition: A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 56B45NI | MN | BLUE CROSS BLUE SHIELD MN | |
| 6236625 | MN | UNITED BEHAVIORAL HEALTH | |
| 154015700 | MN | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Jackie Sue Niemand by the Centers for Medicare & Medicaid Services?
The Jackie Sue Niemand has been assigned the NPI (National Provider Identifier) 1417958893 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Jackie Sue Niemand is located?
The Jackie Sue Niemand is situated at the following address: 6381 Osgood Ave N Ste 8, Stillwater, MN, 550826182.
What is Jackie Sue Niemand's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Jackie Sue Niemand is Clinical Child & Adolescent, and the taxonomy code that categorizes this field of expertise is 103Tc2200X.
When was the Jackie Sue Niemand's 1417958893 issued?
The Jackie Sue Niemand's 1417958893 was issued on 2005-08-09.
When was the information pertaining to Jackie Sue Niemand most recently updated or revised?
The details related to Jackie Sue Niemand, including its address, specialty, and other relevant information, were last updated or revised on 2021-02-10.
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