Healthcare Provider Details

I. General information

NPI: 1386822062
Provider Name (Legal Business Name): JUNE MEYERHOFF PSYD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 1ST ST
MORRIS MN
56267-1408
US

IV. Provider business mailing address

400 E 1ST ST
MORRIS MN
56267-1408
US

V. Phone/Fax

Practice location:
  • Phone: 320-589-7625
  • Fax: 320-589-7686
Mailing address:
  • Phone: 320-589-7625
  • Fax: 320-589-7686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP4900
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: