Healthcare Provider Details

I. General information

NPI: 1205768504
Provider Name (Legal Business Name): JUSTINE GREIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 SLATER RD STE 120
EAGAN MN
55122-4048
US

IV. Provider business mailing address

7368 143RD STREET CT
APPLE VALLEY MN
55124-8698
US

V. Phone/Fax

Practice location:
  • Phone: 612-276-2462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: