Provider Information for 1295922656
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Ms. JAMIE DIANE KLEMENHAGEN MA, LMFT
Sex: Female
NPI: 1295922656
Last Updated: 2019-03-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1295922656 | ||||||||
| Enumeration Date | 2007-10-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2809 WAYZATA BLVD S MINNEAPOLIS, MN 55405-2131 United States Phone: 612-377-9190 | Fax: | ||||||||
| Primary Practice Address | 3128 HUDSON XING STE 1 MCKINNEY, TX 75070-6556 United States Phone: 469-252-7090 | Fax: | ||||||||
| Secondary Practice Address(es) | 2809 WAYZATA BLVD | ||||||||
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