Jackie Sue Niemand, LIC PSYCHOLOGIST

NPI #1417958893 in Stillwater, Minnesota

Provider Information

NPI Number: 1417958893
Entity Type: Individual
Name: Jackie Sue Niemand, LIC PSYCHOLOGIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Credential: LIC PSYCHOLOGIST
Enumeration Date: Aug 9, 2005
Last Updated: Feb 10, 2021

Practice Location

Address: 6381 OSGOOD AVE N STE 8
City: Stillwater
State: Minnesota
ZIP Code: 55082-6182
Phone: (651) 275-9680

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent	103TC2200X
Psychologist - Family — Family	103TF0000X
Psychologist	103T00000X	Primary
Psychologist - Cognitive & Behavioral — Cognitive & Behavioral	103TB0200X
Psychologist - Counseling — Counseling	103TC1900X

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