| Life Dynamics Inc | |
|
6885 Boudin St Ne Suite 100 Prior Lake MN 55372-1432 | |
| (952) 226-2641 | |
| (952) 226-2641 |
| Full Name | Life Dynamics Inc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 6885 Boudin St Ne, Prior Lake, Minnesota |
| Authorized Official Name and Position | Chuck Jorenby (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9522262641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Dynamics Inc 6885 Boudin St Ne Suite 100 Prior Lake MN 55372-1432 Ph: (952) 226-2641 | Life Dynamics Inc 6885 Boudin St Ne Suite 100 Prior Lake MN 55372-1432 Ph: (952) 226-2641 |
| NPI Number | 1932543964 |
|---|---|
| Provider Enumeration Date | 04/21/2013 |
| Last Update Date | 04/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932543964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP3631 (Minnesota) | Primary |
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