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Individual

MRS. ABBY L JORGENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
825 E 8TH ST, SUITE 204, WINNER, SD 57580-2633
(605) 842-7188
(605) 842-7189
Mailing address
PO BOX 435, WINNER, SD 57580-0435
(605) 842-7188
(605) 842-7189

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0578
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10134
AVERA HEALTH PLAN
SD
01
28717
SANDFORD HEALTH PLAN
SD
01
4995629
WELLMARK
SD
01
5836150
MEDICAID
SD
01
5836152
MEDICAID
SD
01
9245763
DAKOTACARE
SD
Enumeration date
12/14/2005
Last updated
08/17/2011
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