DR. Jack Kasl, PH.D.

NPI #1174614150 in Forest Lake, Minnesota

Provider Information

NPI Number: 1174614150
Entity Type: Individual
Name: DR. Jack Kasl, PH.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Clinical
Credential: PH.D.
Enumeration Date: Sep 27, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1790 11TH ST SE
City: Forest Lake
State: Minnesota
ZIP Code: 55025-1968
Phone: (612) 867-8451

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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