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Contact Information

DEBORAH J CLEMMENSEN, M.EQ.
10520 WAYZATA BLVD
WOODSIDE OFFICE PARK
MINNETONKA, MN55305-1511
 Phone: 952-767-0190
 Fax: 952-544-3401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DEBORAH J CLEMMENSEN · (Female)

NPI # 1992711154
Status Active
Credentials M.EQ.
Entity Individual
Enumeration date 07/31/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # LP2635
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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