Individual
JEANNE M DIMEGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3161
(612) 904-4232
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-6005
(612) 630-8242
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13142
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152200
BEHAVIORAL HEALTHCARE PRO
MN
Enumeration date
07/31/2006
Last updated
12/19/2007
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