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MICHELLE K. PEMBLE PHD

Behavioral Health & Social Service Providers Psychologist Cognitive & Behavioral

Provider NPI: 1013116342

Provider Information:
 MICHELLE K. PEMBLE PHD
Gender: F
Not Sole Proprietor

Practice Location:
9555 UPLAND LN N  MAPLE GROVE, MN 55369 US
Tel: 952-993-1440  Fax: --

Business Mailing Address:
8170 33RD AVE S # MS 21110Q  BLOOMINGTON, MN 55425-4516 US
Tel: --  Fax: --

NPI Information:
NPI: 1013116342
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TB0200XBehavioral Health & Social Service Providers
Psychologist
Cognitive & Behavioral
MNLP4824

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 103TB0200X

Type:

Classification:



Definition:



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