Hart, Jordan Lynn

Hart, Jordan Lynn is an sole proprietor health care provider with primary practice located at 5353 Gamble Dr Suite 110, St Louis Park MN 55416-1509. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Hart, Jordan Lynn can be contacted via phone (763) 432-4071.

Contact Information

Primary practice address
5353 Gamble Dr Suite 110 St Louis Park MN 55416-1509
Phone: (763) 432-4071
Fax: (763) 432-4073
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X LP 4313 Minnesota

Profile Details

NPI number 1376524538
LBN Legal business name Hart, Jordan Lynn
Credentials PH.D., L.P.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2005
Last updated Jan 25th, 2011 - about 14 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 1376524538 NPPES
Minnesota Other 472437200 MN MEDICAL ASSISTANCE
Minnesota Other 61-33379 MN MEDICAL ASSISTANCE
Minnesota Other 991N9HA MN MEDICAL ASSISTANCE
Minnesota Other 108187 MN MEDICAL ASSISTANCE

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