Individual
MS. JANE A LEGWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNS MSN LMFT
Contact information
Practice address
4601 EXCELSIOR BLVD, SUITE 501D, ST LOUIS PARK, MN 55416
(952) 926-3744
(952) 926-3735
Mailing address
4601 EXCELSIOR BLVD, SUITE 501D, ST LOUIS PARK, MN 55416
(952) 926-3744
(952) 926-3735
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0070
MN
364S00000X
Clinical Nurse Specialist
Primary
R0794196
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081N5LE
BCBS OF MN GRP
MN
01
—
082N5LE
BCBS OF MN IND
MN
01
—
60068LE
BCBS
MN
01
—
6293312
MEDICA
MN
05
—
717755100
—
MN
Enumeration date
02/22/2007
Last updated
03/06/2013
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