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Casandra Jewel Clark
Student in an Organized Health Care Education/Training Program in Cottage Grove, Minnesota
NPI 1902231210

Casandra Jewel Clark is a Student in an Organized Health Care Education/Training Program based in Center City, MN. Casandra Jewel Clark practices in Cottage Grove, MN. The NPI Number for Casandra Jewel Clark is 1902231210 and holds a License No. LP5929 (Minnesota).

The current practice location address for Casandra Jewel Clark is 8682 Inwood Ave S, Cottage Grove, MN and can be reached out via phone at 651-341-9660.

Location: 8682 Inwood Ave S, Cottage Grove, MN, 55012-9640
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902231210
Provider Name
Casandra Jewel Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
8682 Inwood Ave S, Cottage Grove, MN, 55012-9640
Phone Number
651-341-9660
Fax Number
Provider Enumeration Date
09/05/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
8682 Inwood Ave S
City
Cottage Grove
State
Minnesota
Zip
55016-4716
Phone Number
651-341-9660
Fax Number
person
Provider Business Mailing Address Details
Address
8682 Inwood Ave S
City
Cottage Grove
State
Minnesota
Zip
55016-4716
Phone Number
651-341-9660
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
()
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
LP5929 (Minnesota)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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