Formanek, Jesse Logan

Formanek, Jesse Logan is an individual health care provider with primary practice located at 3721 23Rd St S Apt 201 , Saint Cloud MN 56301-6199. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Formanek, Jesse Logan can be contacted via phone (218) 457-2185.

Contact Information

Primary practice address
3721 23Rd St S Apt 201 Saint Cloud MN 56301-6199
Phone: (218) 457-2185
Fax: (605) 271-3956
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-20-110353 Minnesota

Profile Details

NPI number 1306476502
LBN Legal business name Formanek, Jesse Logan
Credentials RBT
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2020
Last updated Jan 16th, 2020 - about 4 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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