Boerger Wilder, Jodi Rae

Boerger Wilder, Jodi Rae is an individual health care provider with primary practice located at 1245 Washington Ave , Detroit Lakes MN 56501-3905. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Boerger Wilder, Jodi Rae can be contacted via phone (218) 846-2000.

Contact Information

Primary practice address
1245 Washington Ave Detroit Lakes MN 56501-3905
Phone: (218) 846-2000
Fax: (218) 846-2114
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP4398 Minnesota
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP4398 Minnesota

Profile Details

NPI number 1699744227
LBN Legal business name Boerger Wilder, Jodi Rae
Credentials LP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Mar 8th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699744227 NPPES
Other HP37004 HEALTH PARTNERS
MEDICAID 629899100 HEALTH PARTNERS
MEDICAID 1699744227 HEALTH PARTNERS
Other 22522 HEALTH PARTNERS
Other 1032397 HEALTH PARTNERS
Other 310T1B0 HEALTH PARTNERS
Other 171126 HEALTH PARTNERS
Other 6159749 HEALTH PARTNERS

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