Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1952523912 |
---|---|
Provider Name | Jocelyne M Walberg |
First Address | Big Lake, MN 55309 |
Second Address | Elk River, MN 55330-1917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 12/07/2007 |