Provider Demographics
NPI:1164511739
Name:CHOE, JEAN HELEN (PHD LP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:HELEN
Last Name:CHOE
Suffix:
Gender:F
Credentials:PHD LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 JAMES AVE S
Mailing Address - Street 2:#3
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3381
Mailing Address - Country:US
Mailing Address - Phone:612-823-1107
Mailing Address - Fax:612-436-2600
Practice Address - Street 1:717 E RIVER PKWY
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0369
Practice Address - Country:US
Practice Address - Phone:612-436-4800
Practice Address - Fax:612-436-2600
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4382103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical