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General NPI Number Information
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NPI Number | 1689298903
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Entity Type | Individual
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Provider Name | PAIGE JABLONSKI PSYD, LP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 6230 10TH ST N STE 120
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City | OAKDALE
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State | MN
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Zip | 55128-6159
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Country | US
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Telephone | 612-460-0083
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Fax |
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Provider Business Mailing Address
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Address Line | 1876 MINNEHAHA AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-1029
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Country | US
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Telephone | 612-460-0083
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 7019
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License Number State | MN
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