Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | ||
Y | 103TC0700X | Clinical Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1093269128 |
---|---|
Provider Name | Dr. Jennifer Puig |
First Address | Minneapolis, MN 55411 |
Second Address | Minneapolis, MN 55411-3047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2016 |
Last Update Date | 27/09/2016 |