Healthcare Provider Details

I. General information

NPI: 1285318915
Provider Name (Legal Business Name): LAURA JOPP MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2388 UNIVERSITY AVE W STE 202
SAINT PAUL MN
55114-1769
US

IV. Provider business mailing address

301 UNIVERSITY AVE SE APT 206
MINNEAPOLIS MN
55414-1758
US

V. Phone/Fax

Practice location:
  • Phone: 800-945-2401
  • Fax:
Mailing address:
  • Phone: 651-587-0944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: