Basic Information
| Provider Information | |||||||||
| NPI: | 1467855155 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUEL | ||||||||
| FirstName: | MORGEN | ||||||||
| MiddleName: | JORAY | ||||||||
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| Credential: | PH.D., LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 SILVER LAKE RD NW | ||||||||
| Address2: | |||||||||
| City: | NEW BRIGHTON | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551121786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6516289566 | ||||||||
| FaxNumber: | 6516280411 | ||||||||
| Practice Location | |||||||||
| Address1: | 13045 FALCON DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BAXTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 564254201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2188299307 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2014 | ||||||||
| LastUpdateDate: | 02/24/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | LP5716 | MN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.