Individual
MS. JENNIFER NELL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LP LADC
Contact information
Practice address
FIVE COUNTY MENTAL HEALTH CENTER, 521 BROADWAY AVENUE NORTH, BRAHAM, MN 55006
(320) 396-3333
(320) 396-3363
Mailing address
FIVE COUNTY MENTAL HEALTH CENTER, 521 BROADWAY AVENUE NORTH PO BOX 287, BRAHAM, MN 55006
(320) 396-3333
(320) 396-3363
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2814
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026277
PREFERRED ONE
—
01
—
16961
OPTUM
—
01
—
4H134WH
BCBS
—
01
—
6212389
UBH
—
01
—
HP24380
HEALTHPARTNERS
—
Enumeration date
02/05/2007
Last updated
07/09/2007
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