Individual
MS. MARY ELLEN JAEHNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
408 SAINT PETER ST, SUITE 429, SAINT PAUL, MN 55102-1130
(651) 224-0614
(651) 224-5754
Mailing address
408 SAINT PETER ST, SUITE 429, SAINT PAUL, MN 55102-1130
(651) 224-0614
(651) 224-5754
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2035
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62-20847
MEDICA
—
01
—
70995JA
BCBS
—
Enumeration date
07/19/2005
Last updated
07/08/2007
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