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General NPI Number Information
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NPI Number | 1588735856
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Entity Type | Individual
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Provider Name | JANE MARIE LAWRENZ M.A., L.P.
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Gender | Female
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5219 SAINT JOHN DR
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City | ORR
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State | MN
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Zip | 55771-8232
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Country | US
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Telephone | 218-757-3650
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Fax | 218-757-3650
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Provider Business Mailing Address
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Address Line | 79 WESTERN AVE N APT 500
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City | SAINT PAUL
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State | MN
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Zip | 55102-4601
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Country | US
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Telephone | 651-224-2331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP0424
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License Number State | MN
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