Agustin, Judith Louise Ross
Agustin, Judith Louise Ross is an sole proprietor health care provider with primary practice located at 8100 Penn Ave S Ste 150H , Bloomington MN 55431-1346. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Agustin, Judith Louise Ross can be contacted via phone (612) 314-6012.Contact Information
Primary practice address
8100 Penn Ave S Ste 150H
Bloomington MN 55431-1346
Phone: (612) 314-6012
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | MT2659 | Florida |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 2534 | Minnesota |
Profile Details
| NPI number | 1003195082 |
|---|---|
| LBN Legal business name | Agustin, Judith Louise Ross |
| Credentials | M.S., LMFT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2011 |
| Last updated | Jun 10th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003195082 | NPPES |
| Other | 1528451028 | GROUP/BUSINESS ENTITY |
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