| Loring Family Clinic Clinic For Attention Learning And Memory | |
|
430 Oak Grove St Ste 414 Minneapolis MN 55403-3242 | |
| (612) 872-9072 | |
| (612) 872-5605 |
| Full Name | Loring Family Clinic Clinic For Attention Learning And Memory |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 430 Oak Grove St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Gary Gene Johnson (DIRECTOR PRESIDENT) |
| Authorized Official Contact | 6128729072 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loring Family Clinic Clinic For Attention Learning And Memory 430 Oak Grove St Ste 414 Minneapolis MN 55403-3242 Ph: (612) 872-9072 | Loring Family Clinic Clinic For Attention Learning And Memory 430 Oak Grove St Ste 414 Minneapolis MN 55403-3242 Ph: (612) 872-9072 |
| NPI Number | 1568432904 |
|---|---|
| Provider Enumeration Date | 01/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568432904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP1794 (Minnesota) | Primary |
| 103T00000X | Psychologist | LP1733 (Minnesota) | Primary |
| 106H00000X | Marriage & Family Therapist | LMFT1146 (Minnesota) | Primary |
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