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General NPI Number Information
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NPI Number | 1710847637
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Entity Type | Organization
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Legal Business Name | LOOMIS NEURO PSYCHOLOGY SERVICES PLLC
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 7100 NORTHLAND CIR N STE 308
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City | BROOKLYN PARK
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State | MN
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Zip | 55428-1500
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Country | US
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Telephone | 763-344-8861
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Fax | 763-344-8841
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Provider Business Mailing Address
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Address Line | 7100 NORTHLAND CIR N STE 308
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City | BROOKLYN PARK
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State | MN
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Zip | 55428-1500
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Country | US
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Telephone | 763-344-8861
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Fax | 763-344-8841
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Authorized Official
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Title or Position | OWNER
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Name | LANA LOOMIS
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Credential | PHD, LP
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Telephone | 763-344-8861
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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 |
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License Number State |
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