Individual
JENNA ROSE BROIHAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11318 86TH AVE N, MAPLE GROVE, MN 55369-4528
(651) 773-5988
(612) 314-5286
Mailing address
11318 86TH AVE N, MAPLE GROVE, MN 55369-4528
(612) 314-5286
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
107637
MN
Other
Enumeration date
07/09/2020
Last updated
10/09/2025
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