Healthcare Provider Details

I. General information

NPI: 1326269614
Provider Name (Legal Business Name): JOYCE LYNNE JUSTER M.A., LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 WILLSON RD SUITE 405
EDINA MN
55424-1332
US

IV. Provider business mailing address

5100 EDEN AVE STE 121
EDINA MN
55436-2372
US

V. Phone/Fax

Practice location:
  • Phone: 952-922-4643
  • Fax: 952-920-2377
Mailing address:
  • Phone: 952-261-9558
  • Fax: 952-920-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLP 0178
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: