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Individual

MR. JEBEDIAH JOEL SAWYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
4820 MINNETONKA BLVD STE 411, ST LOUIS PARK, MN 55416-5710
(612) 483-4994
Mailing address
4550 MINNETONKA BLVD APT 308, ST LOUIS PARK, MN 55416-5417
(612) 483-4994

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
00232
MN
106H00000X
Marriage & Family Therapist
Primary
1449
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
154H5BE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/22/2009
Last updated
06/22/2009
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