NPI 1013999671

Charles Howard Jorenby, MALP

Practitioner Psychologist Prior Lake, MN

Practice location

Address: 6885 Boudin St NE STE 200, Prior Lake, MN 55372-2091
Phone: (952) 226-2641
Fax: (952) 226-2741

Registered specialties

Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence LP3631 (MN)

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Registry record

NPI: 1013999671
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Nov 2005
Record last updated: 23 Jul 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.