Individual
JENELLE SLOBOF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW/LCSW-BACS
Contact information
Practice address
1016 JAMES CT, SAINT PAUL, MN 55118-3640
(561) 308-5904
Mailing address
1016 JAMES CT, SAINT PAUL, MN 55118-3640
(561) 308-5904
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11655
MN
1041C0700X
Clinical Social Worker
11928
LA
1041C0700X
Clinical Social Worker
SW7155
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152298
BEHAVIORAL HEALTHCARE
MN
05
—
975724400
—
MN
Enumeration date
10/04/2006
Last updated
02/19/2013
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