Individual
JEANNE LYNNE HENKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., L.P.
Contact information
Practice address
300 3RD AVE SE STE 408, ROCHESTER, MN 55904-4613
(507) 529-3622
(507) 529-9190
Mailing address
300 3RD AVE SE STE 408, ROCHESTER, MN 55904-4613
(507) 529-3622
(507) 529-9190
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0358
MN
103TC0700X
Clinical Psychologist
LP0358
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004380453
AETNA
MN
01
—
115730
UCARE OF MN
MN
05
—
526850800
—
MN
Enumeration date
02/28/2007
Last updated
04/10/2019
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