NPI 1477199636

Jared S Spencer

Practitioner Clinical Psychologist Prior Lake, MN

Practice location

Address: 16180 Hastings Ave SE STE 205, Prior Lake, MN 55372-9228
Phone: (952) 443-4600
Mailing address: PO Box 51, Victoria, MN 55386-0051

Registered specialties (2)

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence LP6688 (MN)

Other Psychologist providers in Minnesota →

Clinical Psychologist

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 071.010179 (IL)

Registry record

NPI: 1477199636
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Nov 2019
Record last updated: 7 Jul 2021

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.