Individual
ANNA JORGENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 ROUND LAKE BLVD NW, ANOKA, MN 55303-3315
(952) 247-3581
Mailing address
12337 195TH AVE NW, ELK RIVER, MN 55330-4143
(763) 238-8778
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5V831757234
BLUE CROSS BLUE SHIELD
MN
Enumeration date
09/12/2022
Last updated
09/12/2022
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