Individual
JANE MARIE LAWRENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.
Contact information
Practice address
5219 SAINT JOHN DR, ORR, MN 55771-8232
(218) 757-3650
(218) 757-3650
Mailing address
79 WESTERN AVE N, APT 500, SAINT PAUL, MN 55102-4601
(651) 224-2331
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0424
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D23LA
BLUE CROSS & BLUE SHIELD
MN
05
—
33852300
—
MN
01
—
HP18507
HEALTHPARTNERS
MN
Enumeration date
11/10/2006
Last updated
03/17/2018
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