| Doctor V Llc | |
|
2002 Cromell Drive Hope House Of Itasca County Laprairie MN 55744 | |
| (218) 398-3502 | |
| (218) 326-4390 |
| Full Name | Doctor V Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2002 Cromell Drive, Laprairie, Minnesota |
| Authorized Official Name and Position | Mischelle L Vietanen (OWNER) |
| Authorized Official Contact | 2183983502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctor V Llc 2002 Cromell Drive Laprairie MN 55744 Ph: (218) 398-3502 | Doctor V Llc 2002 Cromell Drive Hope House Of Itasca County Laprairie MN 55744 Ph: (218) 398-3502 |
| NPI Number | 1912311333 |
|---|---|
| Provider Enumeration Date | 06/13/2014 |
| Last Update Date | 07/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912311333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5574 (Minnesota) | Primary |