Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | LP3588 | MN |
N | 103T00000X | Psychologist | LP3588 | MN |
N | 103TR0400X | Rehabilitation Psychologist | LP3588 | MN |
NPI | 1669430237 |
---|---|
Provider Name | Leslie Johnson Meyer |
First Address | Golden Valley, MN 55422-4298 |
Second Address | Golden Valley, MN 55422-4298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
151758 | U CARE (01) | |
6267174 | UBH (01) | |
6269174 | MEDICA (01) | |
63D67ME | BCBS MINNESOTA (01) | |
6552200 | SOUTH DAKOTA MA (01) | |
963371019242 | PREFERRED ONE (01) | |
HP27751 | HEALTH PARTNERS (01) |