Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | 2153-057 | WI |
Y | 103TC1900X | Counseling Psychologist | 4377 | MN |
NPI | 1063715431 |
---|---|
Provider Name | Dr. Jayne Lokken |
First Address | Saint Cloud, MN 56304-0436 |
Second Address | St. Cloud, MN 56303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2010 |
Last Update Date | 07/12/2010 |