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Individual

JEFFREY SCOTT WIDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
403 4TH ST NW STE 115, BEMIDJI, MN 56601-3155
(218) 214-9389
(218) 517-2034
Mailing address
403 4TH ST NW STE 115, BEMIDJI, MN 56601-3155
(218) 214-9389
(218) 517-2034

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
11755-123
WI
1041C0700X
Clinical Social Worker
Primary
29410
MN

Other

Enumeration date
04/05/2022
Last updated
05/31/2024
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