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General NPI Number Information
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NPI Number | 1730388562
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Entity Type | Organization
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Legal Business Name | JOHN A. LORAAS, PH.D., P.A.
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 7373 147TH ST W STE 180
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City | APPLE VALLEY
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State | MN
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Zip | 55124-7689
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Country | US
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Telephone | 952-432-3220
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Fax | 952-891-4622
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Provider Business Mailing Address
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Address Line | 7373 147TH ST W STE 180
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City | APPLE VALLEY
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State | MN
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Zip | 55124-7689
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Country | US
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Telephone | 952-432-3220
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Fax | 952-891-4622
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JOHN ANTHONY LORAAS
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Credential | PH.D., LP
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Telephone | 952-432-3220
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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 | MN LP 3963
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License Number State | MN
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