| Cloquet Psychological Llc | |
|
605 Kallstrom Rd Cloquet MN 55720-9415 | |
| (218) 940-5259 | |
| Not Available |
| Full Name | Cloquet Psychological Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 605 Kallstrom Rd, Cloquet, Minnesota |
| Authorized Official Name and Position | Caroline Louise Nelson (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2189405259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cloquet Psychological Llc 605 Kallstrom Rd Cloquet MN 55720-9415 Ph: (218) 940-5259 | Cloquet Psychological Llc 605 Kallstrom Rd Cloquet MN 55720-9415 Ph: (218) 940-5259 |
| NPI Number | 1720329071 |
|---|---|
| Provider Enumeration Date | 03/12/2013 |
| Last Update Date | 03/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720329071 | NPI | - | NPPES |
| 417629400 | Medicaid | MN | |
| 680001706 | Other | MN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP4209 (Minnesota) | Primary |
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