Individual
MRS. ABBY L JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
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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